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BATCH SUMMARY/CHAIN OF CUSTODY
ANALYSIS TL . Q MATRIX O TlifA DUE DATE L -6 `Lk
r,a`4 rV-rn FIUT
WORK ORDER SEQUENCE # CLINT
J-. 0316 1 -1B QC BATCHREAGE"NP BLANK
J - N ^ k -ix QCBATCHMATMBLANK
1 0 3161 -1M 0(a)
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1 -ZM or 2S
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QC BATCHMA
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QC BAT CHMATROGRFAGENT SPIKE
Duplicate of Sample # $0 3161 01
gv3 tB^lOz I -
g03 i_06 02
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$-03 Z: '7Z0\
Hatched and QC updated by^_ on 3 -2 5-%^
Rec'd in Prep Lab by -- vr.- on 3 -H -W Sop>9RtCttRCSoI^ M-2 C)_
Rec'd in Sep Lab by 6TL1)
on 312- 411 Y
Rec'd in Sep lab by /L( — on SOP# Rte:
ED/CPPT on SOP# R.t -
Rec'd in C . R_ by---4- on 'f I i k r SOpag _ tZ r tilts, 7 ,o t Rn-4 o
Da ta Reviewed by on
sop# t^
^F`T^ ^Re1d
O riginal batch sh t and complete calculation file to be filed with the FIRST Gsted work order num be r.
FORM NO.: R -52. 1/98_ Rev 8
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