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p • • KIPMCOTO� instructions <br /> e u YQf i Pis - p� '� If no TAT is marked, <br /> Ail` TOxics t- ire`" EA will proceed W - <br /> Eurofins Environment Testing Northern California, LLC x .a { ° with Standard TAT <br /> 180 Blue Ravine Rd.Suite 8, Folsom,CA 95630 Workorder#: ( �* <br /> Phone(800)985-5955; Fax(916) 351-8279 K41 1 <br /> page ` of <br /> n Turnaround Time(Specify Below) <br /> Project Name yam) T _ Standard Rush (Surcharges will apply,per availability) <br /> Site Name'. S +-n,t1 {�>j�7" _ sa Lola.rece. a... 'asr Req nested Date(mmudiyy): 5 <br /> ll .Z%hmna 11'1=1_n <br /> Project#'. 4 G? "" 2 a x 'he oh."worFeay. �Number of Days: <br /> Project Manager �7-f`c-� `>Tc�.l... ( Q p Requested Analyses Canister Vacuum/Pressure <br /> �y { Pi a-f S 7 Lab Use Only <br /> Sampler: <br /> - If <br /> Start Sampling Stop Sampling t d <br /> Lab Canister Flow Controller Information Information r <br /> ID <br /> Field Sample Identification(Location) � r ?" � � <br /> Barcode# Barcod¢# z <br /> {C-, `{�. k � - c �z = y <br /> Date Time Date Time " b > <br /> WA 2"Zi< 4111 toze ± , 1e 16 3;3 X K X ac,ly 6— <br /> I <br /> R <br /> Special instructions/Notes: a <br /> Relinquished,,(S' nai r ffil' f n) Date Time Recei d b (Signore Affilta <br /> r 1 9 (5,p} Date <br /> g Time`t <br /> Redo uishe b T t Ll ® V <br /> q y:( nature{Afiliati n) Dat Time Received b Si nature/Affiliation <br /> Y:( g ) Data Time <br /> Relinquished by(Signature/Affl atlord Date Time Received by:(Signature/Affiliation) Date Time <br /> L.bbve Oni <br /> Shipper Name: Custody Seals Intact? Yes No None Condition: <br /> Sample Transportation Notice: Relinquishing signature on this document indicates that samples are shipped in compliance with all applicable local,State,Federal,and international laws,regulations,and ordinances of any kind Relinquishing <br /> a. signature also indicates agreement to hold harmless,defend,and indemnify Eumfins Air Toxics against any claim,demand or action,of any kind,related to the collection, handling,of shipping of samples.D.C.T Hotline(800)467-4922 <br /> b <br />