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t� <br /> , Su#tef,8L •7Sal Sacramento,.C.aA#1 95[8 <br /> 34. 9 1b 911-yduu VAA y#a a�+-U <br /> IVU <br /> ❑819 Strike .,It -9600 FAX (925) 988-9673«` rM CeekC • (925) 98899 <br /> �j p•:Petaiu a, CA 9954• (707)792-1865 FAX (707) 792-0342 <br /> h"t�Y c COD <br /> n a fiA 9407 3•(654} 232-9600 FAX (650) 232-9612 <br /> �.w as � s-ts+ r, tu• .. ,te - _ �� _ .'�sw�x.Y�+ JfaF�,+ 't s^ a�,�`� t <br /> Consui Butt Company, <br /> t - - 'f MA. <br /> ng- <br /> 6,77 erg{requrred)' <br /> Addr8S5- ` 7 7 � />}r :w g(M <br /> - ,� � r } ,,`,:� °,f state k � i� •, pCo�i �.; y' .« J fir' <br /> YTW'Y °'�"kMY'Y ♦jam' 'hVlr 6/1'�/ /V---� a) <br /> R ----t`-F C�tyr�SlAte:w' <br /> k el 9 i$ �'�:�,] s�-�` SAN'V3e.�►:► r� a-rr?ik. 1� � , :m <br /> w ' <br /> } 0 Level B ❑ Level A <br /> Sampler a eVel D�1(standard ❑ Level C x <br /> 'v Analyses Requested <br /> f_ m�otind �1 Work Days e ❑5 Work <br /> P �4 V a <br /> me: 2 Work Days 0`;1Work sClz 8 0 &t ;;'q y= <br /> r Y s,, <br /> CODE: 0 Mise 0 Detect 0 Eval '�eri ed e <br /> _ A ".'Cont== _ S' oi��s : ,� � P �p �� Comments <br /> f <br /> tit, Client Datel F Matnx #of r t -'Si �,� a� " `� � �a� �`� <br /> tSample I D Sampled DescCont. k' �Ty�e* . � mpler � �A 0 �� , <br /> i �VT'�_ 1 S ] t4 1 F C - tia y' ' T S <br /> AQ Cr <br /> -�. ^� T 4ro�„� !f ` ✓, J, I 8 b, , ¢SyG�-3/tYJ R.t ' ��1.�1t 1}'f� , I 1 ! r <br /> Vt"4 i •r r t� �a <br /> i .4 Fes' r O <br /> �'`S`�Y xZ • tit-? , ' k °� �,., , ,w J- i i 1z'!'F� <br /> z 10 <br /> r /7 7N> <br /> S <br /> Relinquished By w Date Time /� Received By L/ Date Time S= = <br /> � I <br /> Relinquished By <br /> Date Time. :,�t Received By Date Time 3 <br /> Relinquished By <br /> Date Time, - f h Received By , r,� Date <br /> Were Samples Received m Good Condltionl D Yes [3 No <br /> (Samples on Ice's ❑Yes Cl No Method of Shipment Page _^of_ <br /> To be completed upon-receipt of report - <br /> 1)Were`the+analyses requested on the Cham of Custody reported i C]Yes; No If no, what analyses are still needed? <br /> 2)10as'the report issued within the requested turnaround`ime� ' ` D Yes,{O No, If no, what was the turnaround time? <br /> Approired by-r r, 6 - F Signature i iE ' > ` '; Company to <br /> I <br />