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rr r r r �Ir �r rr rr r �r r �r rr r �r rr rr r� i <br /> E <br /> CAST* ANALYTICAL LABORATORYCHAIN OF CUSTO <br /> Location 2333 Shuttle Drive, Bldg 9081909, Atwater, CA 95301 Certificate No 2079 r f <br /> OF <br /> Mailing Address 2333 Shuttle Drive, Atwater, CA 95301 PAGE_[ _ <br /> Phone (2091 384 2930 Fax (209) 384-1507 <br /> Customer jq 11lut L" y/)1/JI-W/-ra)tZC REQUESTED ANALYSES Method of Shipment <br /> CA 0 <br /> Address Gc 0 rx <br /> dtr n t� f, <br /> � W <br /> j <br /> City/State/ZIP r (�A q5--!s o Notes <br /> k Phone 1 FAX z'`�' I !"1!/ �, a `� �, o <br /> = w a <br /> Prol # �t�ri- L r C r� (.UK �} o LL d � _ = O <br /> Report Attention , f' � r w <br /> Sampler Signature 3 ° m `t <br /> m <br /> Printed z <br /> Lab ID# SAMPLE ID DATE TIME DESCRIPTION/LOCATION L 1 <br /> I � <br /> LA <br /> I UM TIAN Pa <br /> r <br /> HE D AC AB EN <br /> a <br /> Total number of containers submitted to <br /> Signature printed Name Date /T—iime lClompany Name :t� the laboratory <br /> Relinquished by s—d'�P-r.=—._ P l i L LSC C ki�C Y) ' �'A�/ f /��.y+ /RS7 f ! f7r!(� Note All special requests(e g quick <br /> Received b �f/'I� Cwt S ,��V! �4�! turn times)must be cleared through <br /> y authorized laboratory personnel <br /> Relinquished by <br /> Received by <br /> Relinquished by RESULTS DUE <br /> VERBAL 1NRIT rEN <br /> Received by <br /> f <br />