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i <br /> PREC)LSIONEN ,� - . E CHAIN 01F C UTD_D <br /> MW ow",1 <br /> Client: �� 8 � A� �q�,�� Sampler(s)_ az- <br /> ,yl�_ Rush Analysis: 5 Days_2 Days_2�bhas� <br /> j Composite Sampler S� S&Ibject to surcharge <br /> Customer 4 <br /> Date: Time: QA/QC report required:cl Yes no <br /> Address: -5 'Lg�jz Ste" Subject to Surcharge Field Sampler: if yes,To: State Tient Other <br /> E <br /> fS I e �e-7- �a Time Mli age <br /> Lab number: 8 �I <br /> ab number: <br /> i <br /> Z5 <br /> FAX: 9 403 -q0,5c— & � Sam'ra,pll e Tempe ratua°eo Celsus � <br /> o <br /> ()leaking. ()Broken.( )VOA Headspace � <br /> Project name: 113uRiV OFF ASS4L a M <br /> o Custody Beall O yes Ono <br /> Fq A N m P <br /> a o u z <=i <br /> Contact person:I ��� ����� o �� d v d x � ■ ■ <br /> � o <br /> ■ e (Affee Chest ()UPS ()Fed Ex ()Drop off ()©t' <br /> Sample Date Time w �'o d N U V� <br /> Number Location Descript1oII� L B c � � z w e ■ ME <br /> Sample SampleBURN 6F5 AMA <br /> z'y a o v <br /> a <br /> Tl� <br /> i 1 <br /> I <br /> uished b n �'�•,® pp � 9 <br /> q Y I9at im Received by: <br /> Relin 1Date A p IIrime p" <br /> Relinquished by: Date <br /> -Time-Received by: Date Time <br /> Relinquished by: Date -Time-Received by: Date Time <br /> j <br /> 3935 N. Coronado Ave. '^ Stockton CA 95204 * Telephone (209) 477-8105 :': FAX: (209) 546-7497 * Email: jhvle ftetallab.corn :Yv.petalla?b.coruz <br />