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LEFT FFArN M M W M M ! M M Or%alywsesequest <br /> M <br /> • AB <br /> ORATORIES BSK st,e iQn <br /> �� /C/���� Chain of Custody <br /> 1414 Stanislaus Street Fresno, CA 93706-1623 / / Requested Analyses <br /> (2o9) 497-2888, 800 877-8310 (209) FAX 485-6935 <br /> Client Name Peport Attention Phone/ <br /> AddressProfeCt Quote or PO FAX <br /> rJoe, leg 14 <br /> City,State Zip Copy to <br /> System I` <br /> 1A ts�OiAT Sampled Off+ [fQComment or <br /> Date Time 414 <br /> ` i { Sampled Sampled Sample Description/Location Station Code <br /> C Jam[} <br /> �J <br /> ,a <br /> t W <br /> S <br /> s 3 <br /> �s <br /> OrAxi <br /> M ' <br /> 'f <br /> w� <br /> y <br /> 7 <br /> Matrix 7)(pe L Liqui S Soli Gas Additional Services tion]Sery 7Vn' <br /> _ e a <br /> Payment Reccfyed tivitt;Deiivey ! <br /> Type of Hazards Associat Samples ]tush Priority Day [] 5 Day jDate:QC Datapackage corIV(circleone) '"�"""r` <br /> [] Farina]C of Custody <br /> to <br /> Signature Print Name Company Date Time <br /> Relinquished f� <br /> Received/ReUngeis by <br /> L'1109-i' <br /> 8 of iv—_ _ 7 <br /> s !1 <br /> Notice Payment for services endered as noted herein are due in full within 30 days fra when invoiced If not so paid account balances are deemed delinquent Dalmqueni balances are subject to monthly servicelre b ng charges and interest cal <br /> culated al f 1/2%per month,1896 per annum BSK&Associates shall bs entitled to recover on delinquent accounts,costs of colloobons including attorneys`tees incurred prior to or in Iltigabon whether concluded by judgment settlement compromise <br /> or otherwise The person signing for the Client/Company expressly acknowledges that they are either the Client or authorized agent of the Client <br />