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� sir ■... e� ■tom �r tttt! � � � I♦ � � � �_ <br /> CA E ANALYTICAL LABORATORYCHAIN Q� CUST Y <br /> Location 2333 Shuttle Drive, Bldct 9081909, Atwater, CA 95301 Certificate No 2079 <br /> Mailing Address 2333 Shuttle Dnvr Atwater CA 95301 PAG f_—t—OF� <br /> Phone 12091 384 2930 Fax (209) 384-1507 <br /> Customer !ri L,7�- REQUESTED ANALYSES Method of Shipment <br /> Address ,f Jtoi <br /> eztl <br /> CltylStatelZEP � �a x � � w - <br /> ° " z Notes Cooler Zece4be <br /> Phone / FAX r,! - U! —// a a w s $rA4ed <br /> Prot # IPO # '� a � W � z W °° o <br /> Report Attention w a .. a a ' u <br /> Sampler Signature FL <br /> a $ m ~ a <br /> Printed «� <br /> Z <br /> Lab ID# SAMPLE ID DATE TIME DESCRIPTIONILOCATION O6 <br /> + <br /> 00 <br /> (11) <br /> L4) _s— <br /> L4) <br /> - `s_ k- <br /> ++ <br /> �s= l <br /> 34 <br /> (+� -f5lJ <br /> � I <br /> Tolat number of containers su mitt io <br /> P)glipture Printed Name Date Time Company Name the laboratory <br /> Relinquished by / y /� • y f C c s ` 5 2—e— Note All special requests(e g quick <br /> by <br /> C turn times}must be cleared through <br /> Received <br /> authorized laboratory personnel <br /> ReLnquished y <br /> Received by <br /> Relinquished by man ccj PROPRATE RESULTS DUE <br /> ftecewed by M pg VERBAL WRITTEN <br /> i <br />