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06 <br /> eurofins 1of1 <br /> Agt Toxics For Laboratory Use Only�� t i r, <br /> PID: Workorder#: Click links below to view: <br /> 180 Blue Ravine Rd. Suite B, Folsom,CA 45630 Canister Sampling Guide <br /> Phone (800)985-5955; Fax(916)351-8279 Helium Shroud Video <br /> Client: G-PID: Special Instructions/Notes: Turnaround Time(Rush surcharges may apply) <br /> Project Name: Select TAT from drop down box 9•T' <br /> Project Manager: llnh�� ! t) t[ijr1nUPdn P-O.# Canister Vacuum/Pressure Requested Analyses <br /> Sampler: L/=t• 1 / h,,,a Lab UseOnly - <br /> Site Name: `, <br /> Lab Start Sampling Stop Sampling _ •y' <br /> ID Sample Identification Can# Flow Information Information �- �. a °: • <br /> Controller# <br /> Date Time Date Time c LL ff ii t? <br /> Air;z— G ✓ p <br /> :5 r C p h <br /> J3 — 2Gf a� wt <br /> 5 v` pw q Z <br /> '^ zb <br /> Relinquished by:(Signature/Affiiiatio _ Date Time ;q Received by: Signature/Affiliation) Date Time <br /> f /2 �/ll ) U t t 7�Z ci 7 <br /> Relin ished,by: (Signature/Affiliation) Date Time Received by: (Signature/Affiliation) Date Time <br /> Relinquished by:(Signature/Affiliation) Date Time Received by: (Signature/Affiliation) Date Time <br /> Lab USA Only!, <br /> Shipper Name: Custody Seals Intact? Yes No None <br /> Sample Transportatio otice: Relinquishing signature on this document indicates that samples are Shipped in compliance with all applicable local,State, Federal,and international laws, regulations,and <br /> ordinances of any kind. Relinquishing signature also indicates agreement to hold harmless,defend,and indemnify Eurofns Air Toxics against any claim,demand,or action,of any kind,related to the collection, <br /> handling,of shipping of samples.D.O.T Hotline(800)467-4922 <br />