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K L E I N F E L D E R <br /> PROJECT NO. PROJECT NAME "j RECEIVING LAB: <br /> NO. TYPE <br /> L.P.NO. SAMPLERS:(Signature/Num L <br /> (1710.NO. OF OF <br /> INSTRUCTIONSIREMARKS <br /> CON- CON- <br /> DATE SAMPLE l.D. SAMPLE 1.0. MATRIX TAINERS TAINERS I <br /> TIME <br /> MWDDIYY HH-MM-SS <br /> x, <br /> f I x. x <br /> 'k <br /> 5 <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 411 <br /> 12 <br /> 13 <br /> 14 <br /> 15 <br /> 16 <br /> 17 <br /> 20 <br /> Relinquished by:(Signature) Date/Time Received by:(Signature) Instructions/Remarks: C)I Send Results To: <br /> aa <br /> KLEINFELDER <br /> Received by:(Signature) 2825 EAST MYRTLE STREET <br /> Daterrime <br /> Relinquished by:(Signature) STOCKTON, CA 95205 <br /> (209)948-1345 <br /> Relinquished by:(Signature) Datefrime Received for Laboratory by:(Signature) Attn: <br /> M-60 White-8a 1 mpler Canary-Return Copy To Shipper Pink-Lab Copy <br /> CHAIN OF CUSTODY <br />