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'- 'TER CO"O SAMPLE $ VVIMAL AND T [AC } <br />milli <br />0 <br />Date Data &itered <br />Data Entry By <br />i,s n Laboratory te`" <br />ry Destination if net Cottee: <br />ter O[[ =mwimontioa <br />Air Water f_ Soil Odmer ( <br />'400 series r"aested• r •� �, - <br />f 4e <br />hiding Tie): ; <br />;< �►r instractions: <br />_yam• -' „�`a - - _ - :� "-= ;� <br />P . <br />? <br />it TICS initial ( ) and explain below. <br />of noted Item: <br />`.. 3 Cbmk # addulawl attaci omos. <br />_ - valid? YES { ) NO ( ) If NO, explain: <br />QAC Date <br />