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N Awke-dT & Chlakorat,c� Chain of Custody <br /> A p C, 13760 Magnolia Ave Chino CA 91110 <br /> Tel: 904 590-1828 Fax: 909 590-1498 _ + Please Print in pen �uPage of <br /> Client: illj �rr Q..� 1 C� <br /> J�� <br /> Coatart: TtJ # q btu-bt5b Fax # 4T ! ��'7 '�4c <br /> Address: }(p Nfi City: -p�V i(} State: - <br /> MQtJt 1 FE I —�_gt_ - — CIA Zip code: ----- <br /> Rill to _ — -- _ Analysis Items <br /> Project Name/Code LAT �� Joh # � P.O. # — ` U �- White- With rcpurt <br /> Project Address y� �—� <br /> - }� - 1 ] -' — --APCL Quotation # A— ' I Yellow-Lah enpy <br /> Dne Date: ❑regular nrneh: dais honrA Sampled byN p Fink originator <br /> Field Sample Samt>1e Bate <br /> Time Sample Prrxr- #of <br /> ID Nu. _ Description _ Collected Matrvr vation Containers Rematice <br /> XIX <br /> - --- LF _ 1-°i 1` ,�- I <br /> - -- LFC(o kk r mal OX X <br /> 1 �CIIJ _ _�_ <br /> M IT-� e� o tomer X IQrr� <br /> -- <br /> UIa Zlf -hi. tr <br /> Cr — — — <br /> _�(Y� <br /> -- - - <br /> --- - - <br /> tK Etrquirement: nAegul r; ❑QA/ port; ❑WiP; ❑Raw Data; ❑Brtendted Raw Data []CLP; ❑ACE QAFCEE ❑NUMA __(B,Cor D); ❑Other_____.—(pleaer eciiy) <br /> M _ f <br /> Sample Duponal: UReturn 17iDispoeal by APCL ❑Hold for days after recaring date. If not fled,sampixs will Us diadrdad 46 days dt"awntpl..a ,@ received. <br /> 0 Sample Conditions: ntntact; TQ_Bmken. Cnnler Seal ❑ ❑ as E Temperature: n Minns ❑Cold <br /> O []intact; Broke»; None. T o <br /> O -- -- -- -- — -------- -- -- <br /> N <br /> Relinquished b l _ Date/'Time S-7-o f /1 g Received by 14oQ Date/Time '5-7-01 <br /> Relinquished— by PeT�i_ MOofr — nate./Time > ?_ U l /19 80 Received by �.j F, g,z q 11�1 to/Tifne rj,7L o <br /> 4.y.0 USE ONLY Service # A -- - - Note:C(z s. <br /> Cr <br /> I <br /> _ _ _ _ <br /> Clients understand that all terms described in the propals,goo <br /> ostotions for thio project,and/.r the general terms pro+idWin the 1) t APt'T,pricr schedules will be followed. P rear—the nght <br /> to terminate its seMee or withhold delirery of any reports,if in APCL's sole discretion the tirtoa of the project have been brolten- <br />