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3050 Fite Circle,#112 ORf\OR��R �. <br /> ��� Sacramento, CA 95827 REMARKS: VVI <br /> Vw <br /> 21 ff �� � �'""' Voice: (916)362-8947 <br /> En virc>nm�ntr3/ /_aboiatori�s Fax: (916) 362-0947 <br /> Email: SPARGER@SPARGERTECHNOLOGY.COM age: I o <br /> Project Contact(Hardcopy and/or PDF to): California EDF Report? <br /> �(,r O YES ANO Chain of Custody and Analysis Request <br /> Company/Address: OPTIONAL Analysis Request TAT <br /> J Sampling Company Log Code: �, /� y `7 <br /> Phone#: Fax#: Global ID: i " <br /> Project#: P.O. #: EDF Deliverable To (Email Address): <br /> a <br /> in <br /> co <br /> co O N N m ~ <br /> 00 pp. m W <br /> P�)ect Name: Sampler's Si nature Sampler's �e(PRINT): i'n m w w LU 3 <br /> in M M d x ` <br /> r N W r L <br /> N O N <br /> Project die s:� ontainer Preservativ Atrix � m = _ ; 0 <br /> tll � g � 0. 0. � v a c� � <br /> f, � Sampling mM o W � N � N � 0 M <br /> ��" D N <br /> r 1 L44- Cj Q m a rd M = N L <br /> V O V V <br /> C O W 00 d h m N d 0 ) <br /> J W W W X M R U' >. T a a N t <br /> NO. SAMPLE iD Date Time W J W w = _ = x x x u a <br /> o _ z W O Q O F- 0. 0. 0. 0 0 0 0 �, a <br /> v cn 2 T CJ Z (n m m F F- F �n r� r� J W > J <br /> 1 (ADG-t Xi J4-0 t3 '3o <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> Relingui ed By: Date Time Relinguished By: Date Time Relinguished By: Date Time R cceived By: Date Time <br /> Adbuti6n((WHlTE)-LAB, (YELL W)-ORIGINATOR Bill to: <br /> PLEASE READ REVERSE SIDE FOR TERMS AND CONDITIONS <br />