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11111 ,51 <br /> h.y 4 <br /> Z <br /> e c o Pia ei <br /> ba:A <br /> CHAIN-OF-CUSTODY RECORD <br /> MPLER.t Signature J <br /> pNto shipped Carsfar <br /> a <br /> Airbill No. e„ coolar No. <br /> :� •��3.1D Zl F_..r-L+4L�fs"iZJ : `��� ,r <br /> Easeco-Cal Lab CILat Nw= <br /> _.144 ludustritl Blvd. COMP-Y <br /> West Sacramento,CA 95691 <br /> (916)372-1393, j <br /> I ;ENTIaN:� a3 _ Phons <br /> OJECT`IAME_''.`�--�i L.i tX]—�O� PROJECTNO. P.O.NO. ` <br /> a::.linquished by: (Signature) Received by:(Signature) Date Time <br /> i3 <br /> elinquished by: (Signature) Received by:(Signature) Date Time <br /> i Ts11Cn by ( g ate.re / Ree '"'ed at by ign Je) Dat Time <br /> ju.Llinquished from i2,6'b9: (Signature) RAczived by:(Signatu } Atte Time <br /> ANALYSIS REQUEST <br /> Sample ID Saffipi� Data/Tims Sample Condition <br /> 1-,-dumber Description Sampled Analysis Requested L7pors Rectiipt <br /> .. 1,A� �- "��..• <br /> � w <br /> tipccial instructions/Comments: <br /> i ]lezD �� rel APRtL . <br /> tA <br /> I N2. TE: LJNiJS'-ED PQRTION$ OF Na`t-AE-QU5 SaMPLES WILL E T Nr <br /> �"`r �eCted <br /> ",,j yticsl Immediate Standard <br /> T.AXs: Attention (200%sura.rs•) r�,! RUSH (so-tar9�sureh•9e) <br /> Cal Lab ID Number: (for lab use only) <br /> �.� Client Retains White Copy Only <br /> (]ta�fred /dT) <br />