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0 <br /> �`' "' AMERICAN ANALYTICS CHAIN-OF-CUSTODY RECORD <br /> 9765 ETON AVE, CHATSWORTH, CA 91311 DATE <br /> Lit (818) 998-5547 (818) 998-6548 1-800-533-TEST 1-800-533-8378 FAX (818) 998-7258 PAGE OF� <br /> AA CYentD�f/1 uk <br /> r�� Phon `� �� Name <br /> Project Managerk A f A ^-�, PO No Sampler's <br /> K /�tom/r/ SI nature <br /> Protect Name C, /2/ Project No Project Managees <br /> t/ l j Signattre <br /> Job Name ` `J Detection ANALYSIS REQUIRED <br /> � <br /> and tJmlts <br /> / / / /// <br /> Address <br /> Test Test Requirements <br /> AJC Cunt's sample tkmbe► Name <br /> to r LD Data Time of N <br /> T�`p° Containers <br /> — <br /> CVs-.sem' -- � — -- — – ---- - <br /> 2 ws4.s —� ---- —— <br /> ,oS t-7LO — - - <br /> 1 — <br />� <br /> 1 2A Y, — -2 <br /> 220 3 YJ IX P I.,rG- Thkl cfc.,63' <br /> 1 o w �a x zJ Z <br /> LJ�L <br /> NAMPLS INTJDGRPiT•TO IN BT R10MVINO LAB Rwquisbd by Date T/3:3- <br /> ime ad by <br /> 8awlee Intact Yea No 'zW f 3:3i° t9•A <br /> Samples Propelty Cooled you No RebvJahed by Date Tina Recelved by <br /> 8nrnplea Accepted Yes No <br /> It Not Why RaeWisbad by Date Time Recetvad by <br /> AA Protect No60 <br /> / _ Rerngnl%hed by Data Time Racelved by <br /> DISTRIBUTIOM White - Laboratory, Canary - Laboratory, Pink - Account Executive, Gold - Ctlent <br />