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0 1 0 - <br /> Lntech Anal ical Labs Inc.� <br /> 525 Del Rey Avenue, Suite E • Sunnyvale, CA 94086 •Telephone (408) 735-I550(800)287-1799 • Fax (408)735-1554 <br /> Chain of Custody/Analysis Wor <br /> k Order <br /> Client deOvJa�a U�Dy In, Pro e -7 9 <br /> -I �� ct ID f U LAB USE ONLY <br /> Address j D �ra <br /> SU' <br /> Dy Purchase Order # <br /> 0ay, 1av-\Aj Sampler Company Telephone <br /> r""`� 4 .0v "-10- l!�p Samples amved cl lled and intact <br /> Contact ;a,nn� ' o 1.6! 7:1,3 C. Yes No <br /> Telephone # 51 p _ gq( 3 — 5) Special Instruction Comments <br /> Notes <br /> Date Received <br /> Tani Around � �d r <br /> Sample Information Re nested Anal sis <br /> qq � <br /> �]Dniposlte <br /> sampleLab It S,un >lMat rrr ColleLted Collected Pies Container � � � O <br /> (2-53 `lo.,l <br /> —1? WAW— 1 X25 3 �oNr <br /> E <br /> �1� S V'-%w —2 <br /> Jill] ES <br /> yt <br /> RLwvcd By <br /> Date Time <br /> RLluscl BN Rccened Dy Date <br /> Time <br /> Received Fav <br /> Date Time <br />