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/ L4010 PIMUNr' �■■ Al111111111W-CINDY �� <br /> CONCORD, CA 94520 AND ANALYSIS REDDEST <br /> ' INVI16NM[N1Al (415) 685-7852 <br /> 'ASoaArollr! INc (800)_423-7143 OUTSIDE CA 800 5443422 INSIDE CA <br /> Company Name T ,�^ Phone# <br /> 1 rl� FAX!f 0 ❑ <br /> Company Address Site location w ❑ ❑ <br /> ❑ <br /> C N L-0�f S�'O GT v `� ❑ ❑ ❑ ° <br /> Project Manager Client Project ID (Ar} O 1'� I I ❑ + 0 13 D ❑ <br /> x <br /> w m to y t ►- v <br /> N rc �- NAME So o N �_ o ❑ ❑ ❑ ❑ z z ❑ oy ❑ ~❑ <br /> I attest that the proper field sampling Sampler Nam (Print) a ❑ rn ❑ ❑ ❑ ❑ <br /> � � � a <br /> procedures were used during the collection 6r, 5 � N O 0 0 ❑ � p ❑ m ❑ a a <br /> of these samples 1 V 0Method $ �n ^ _o � ❑ ❑ <br /> mMatrix Preserved Sampling a ❑ o +a++ °� I ❑ C, a ❑ 0 a. ❑ i-i <br /> Field I GTEL c -� ❑ ❑ <br />� <br /> Sample Lab # a 'u � rc � � � � cn a C4 s: � <br /> Lab use only)ID r <br /> tl01 Q 0 ft US <br /> a O Y x Y v � �a O � � � 2 2 O � W w W W W W � W W P W <br /> o <br /> s <br /> q ZID <br /> 10 <br /> '4 <br /> i40 <br /> 6 <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS <br /> Priority(24 hr) ❑ OTEL Contact <br /> Expedited(48 hr] ❑ Quototantract A <br /> 7 Business gays ❑ Coritmatlon <br /> Other PO 8 SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot M Storage Location <br /> Business Days ❑ <br /> GA 1 OC LEVEL <br /> BLUE❑ CLP❑ OTHER FAX❑ Work Order M <br /> Relinqui ad ler ate Time Received by <br /> yS <br /> cus�oCUSTOMRelin ed by Date Time Received by <br /> RECORD Relinquished by Date Time R by Laboratory )6, <br /> x I � <br /> l�_149 1A �C y <br />