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_ -w wr w� r ■w cow cow w� co w �■ w� w w w w co w <br /> - - Chain of Cu d Record <br /> � � Date <br /> -0 148 S Vinewood St, Escondido, CA 92029•ph 760 735 3208•fax 760 735 2469HPL Protect# � � � �3 <br /> 432 N-Cedros Ave,Solana Beach, CA 92075•ph 858 793 0401 •fax 858 793 0404 <br /> LABS 0 2373 208th Street Unit F-1,Torrance,CA 90501 •ph 310 782 2929•fax 310 782 2798 Outside Lab <br /> Client SSaL Collector 40�611` Page / Of <br /> Gh <br /> Address I&Z4 G�I�sAPC.4.el DOX ?F7� qZ5 rZ7 DyLS 4� wl <br /> - _.._.__... Client Protect# y,` Protect Manager A <br /> MAJ P116 cf-4 J 7Z 7, Location /ty/ f oCl r7 k <br /> Phone S6p Ir oco Fax 5 — �S Turn around time <br /> Notes "1 8260B Sample Receipt <br /> C to <br /> E d o intact ❑Yes❑No <br /> 8 <br /> mco bo <br /> Seal Intact Q Yes❑No❑N/A <br /> r m y t v <br /> rn m 0 m Cold D Yes Q No <br /> o ro m a x u w J N/A(Received on Site) v <br /> W c o <br /> — m Sc o m o <br /> Sample Container x = N N ;� �' Q -E m <br /> - Sample Depth Time rDate Type Type QL as 0 0 m p O 0 LL j Field Notes F <br /> ��� �`Za IIsi o f` GiLV VDA S X <br /> w-3 <br /> 12-,30 <br /> - <br /> - YO <br /> w�7 Wye, <br /> w-Y- - 17- <br /> — Re6ngwshe ignat e) / (company} Re by (SlgnaEy�ca}� (co pan J Date lime <br /> Relir1fiuishddd by (Sign re) (company) Receiv by (Signature) (company) Date Time <br /> Relinquished by iSognature) (company) Received by (Signature) (company) Date Time <br /> "Slgnaturo constitutes authorization to proceed with analysis and acceptance of conddlon on back Sample disposal Instruction 0 Disposal @$2 00 each 0 Retum to crrerrt 0 Prckup <br />