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2795 Second Street, Suite 300 Calscience <br /> KIFFO Davis, CA 95618 7440 Lincoln Way <br /> Lab: 530.297.4800 Garden Grove, CA 92841-1427 <br /> Analytical LLC Fax: 530.297.4808 714-895-5494 COC No. 71830 Page 1 of 1 <br /> Project Contact(Hardcopy or PDF to): EDF Report? YES Chain-of-Custody Record and Analysis Request <br /> Troy Turpen <br /> Company/Address: Recommended but not mandatory to complete this section: <br /> Analysis Request TAT <br /> Kiff Analytical Sampling Company Log Code: SIRC <br /> Phone No.: FAX No.: Global ID: <br /> 530-297-4800 530-297-4808 SL0607737442 <br /> Project Number: P.O. No.: Deliverables to(Email Address): <br /> 185702030.200.005 71830 inbox kiffanal tical.com o <br /> Project Name: Container/Preservative Matrix > tv <br /> ca <br /> 1Q10 QMS-STTC o 0 <br /> 1 cc <br /> Project Address: Sampling 0 M <br /> Z Q L.o <br /> 0 w LL <br /> 0 <br /> Sample a <br /> E o <br /> Designation Date Time N <br /> TS-4R 02/03/10 10:55 1 X X X / <br /> TS-5 02/03/10 09:25 1 X X X <br /> TS/M-2 02/03/10 11:25 1 X X X <br /> Relinquished by: Date Time Received by: Remarks: Please refer to attached Test Detail. <br /> / / N0f-) <br /> Relinquished b Date Time Received by: <br /> Relinquished by: ate Time Received by Lab a ry: Bill to: <br /> Accounts Payable <br />