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Relinquished by: (Signature) Received at lab by: (Signature) , Date - Time <br />Relinquished from lab by: (Signature) R cve ° Si !ure) Date ( 1 <br />0, ip -7/10 get ANALYS REQUEST <br />Sample ID <br />Sample <br />Number <br />_ <br />�... EnsecO <br />Pap Of <br />35QGto � <br />► - ri <br />350G'7 <br />CHAIN -OF -CUSTODY, RECORD <br />- <br />Date Shipped a,. Carrier <br />Phone <br />Airbill No. Cooler No. <br />SHIP TO: -. <br />SEND RESU TS TO: <br />Enseco-Cal Lab .. , <br />Cli t xazne ` <br />2544 Industrial Blvd ; % ", ` <br />Coes pang <br />- <br />5691 <br />West Sacramento, CA 9569l <br />-. atddaw.`< ° A'i q5 �xlot�r-� <br />P� <br />a(916) 372-2393 .` ' : ' , { <br />-..-:-- <br />jSw4 TCS C.,A . <br />Ci 5'if a -Z. <br />ATTENTION: <br />PhoneA. <br />_ .. ..:_ <br />PROJECT NAME <br />of • ZZQU—CSZ <br />PROJECT NO O. NO. <br />Date Time <br />. <br />�qlinqui y: re) <br />Received by: (Signature) <br />�— <br />Re 1nq ishc i ure <br />Received by: (Signature) <br />Date Time <br />Relinquished by: (Signature) Received at lab by: (Signature) , Date - Time <br />Relinquished from lab by: (Signature) R cve ° Si !ure) Date ( 1 <br />0, ip -7/10 get ANALYS REQUEST <br />Sample ID <br />Sample <br />Number <br />Description <br />.3500-S <br />4 0 <br />35QGto � <br />► - ri <br />350G'7 <br />3 50q <br />35og 8 <br />350 <br />-r- P, <br />Date/Time Sample Condition <br />Sampled Analysis Requested Upon Receipt <br />Ali 2QC fl 41-5, <br />b U l <br />"T bL, 310 1 1 0' <br />.b 3� <br />M, ACUL I IJ ( 61d 1 by 2-4 Se <br />kt r5 Eh LC, i �-uAr<A-C.e " 6� 2.0 17r /. <br />Ill L... 21n M ....— -7)/ 11 1 <br />Special Instructions/Comments: eptl. to Q 1 � tea Z <br />S� e r coo{ � � �' � C a <br />tA <br />I , <br />l U <br />w/ /( F71 -Y 41uj,4 o4 7-,' 3 7 -F6i ..PC,04-P 57c,--r-n z <br />NOTE: UNUSED PORTIONS OF NON -AQUEOUS SAMPLES WILL BE RETURNED TO CLIENT <br />Expected <br />Analytical Immediate <br />T.A.T's: Attention (200% surcharge) RUSH (so -100% surcharge) Standard <br />Cal Lab ID Number: (for lab use only) <br />g 8114 <br />Q Client Retains White Copy Only (Revised 1/87) <br />C <br />