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x <br />> <br />0 <br />0 <br />ti <br />in <br />& <br />no n <br />CD <br />4 <br />.&go <br />- <br />CD <br />O <br />4 <br />00 <br />CY <br />Cr <br />8 <br />3 <br />2: <br />amin <br />0 <br />4 <br />Laboratories, Inc. <br />Chain of Custody Form <br />Reparr Ta. <br />Client- <br />Pr-j-ct <br />Page of <br />Attn:Project <br />Name: r.C'3� �Z&' <br />Comments: <br />Street Address: I <br />City, State, Zip: <br />ILI I dAZ04'.loballlD#: <br />C'AqW <br />ISam pler (s): <br />Email Address: <br />Work Order #- <br />F. <br />Sample Matrix <br />., Other % <br />I <br />Are there any tests with holding times less than <br />ar egaal in 48 hours? <br />El Yes NO <br />Standard Turnaround = 10 work days <br />Notes <br />Iz— <br />r1rX 01 <br />SUB-0, U, <br />Same as above EDF Required? Glob i ID <br />la, EDF) <br />System # <br />(Needed to, EDT) <br />Client: <br />Address: <br />❑ Yes F-1 No .Fel Date <br />t�r B <br />I 1a I1 <br />Time 1. Received By <br />IF, -!� 1, <br />' <br />Dote Time <br />0-19-1111531 <br />City: <br />State <br />Zip <br />Send Copy to State of <br />CA? (EDT) <br />2. Re wished Bl-v..�/ Da tt <br />.��'A� X -116-y'-- <br />Time 2. Received Ay- <br />/?00 <br />5 Date Tina <br />•1106 <br />Attn: <br />El Yes ❑El No <br />finquistrH By Date Time 3. Received By <br />�=L� !L'q-g !�g ) <br />Date , Time <br />w, Lid) <br />PO#: =j <br />BC Laboratories, Inc. - 4100 Atlas Ct. - Bakersfield, Ch 93308 - 661.327.4911- F 661.327 .1918 - --*d, <br />h(,l abs.corn <br />