Document 93L6VwwzdkK72gqwXjOrEXzk6

) y y n Vn * y/ / / / '-y ) 1 ' / 'y y. ' / i ? r :/ //j a y .-'"1.yo /^- . r*S11 J^ J J ,>. - ^y* O / ; 7( /' '''/0 yy / V 7 ' .' j r *V ,y .y , v J V y y -; '.* : > ') \) * ^ >y/ *>t'^ y >''1./'% -/% ~s' /. VS. ' ,/3 "vV //' / - F/ / (, y / /o // 5 ; /U < ' ') \ > , ; .* , v ' ,'* y *" L ' * Y* ' V / 1 i/ / . y^ / y - \ - - .' ' > y y y / ' " ' " 3 -/ - '; ,> y -./ f ."tl >', 1. 2 ' W 'i -`7 v^ fe* ? yC y) 0 - 7 - V O V / r L '* o r/ /- , c / ' 2 f7 .< 7 <; - y / J '' ' V7 " r y j b s - -V ; J ;'5 \ *i- y 2? i s' 0} " ' y -N - 7 ' 1 j y o >y~- ,w ? -y / y ":, -<y 7' ; /j / 7/ ^ /j; /y // 7/ 5 / / / '( / U f y i ; ) . ; . 7 y/ "' -- - - ; A N A LY S T WORK SH EET 3. SEALS [3 INTACT 1 1BROKEN QU NONE 7. DESCR IPTION OF SAM PLE < - ---------- T ^< 1. P R O D U C T 7 0 /C . ./ 4. D A T E R E C D 5. R E C E IV E D FROM 7/ 2. S A M P L E N UM BER 6. D IS TR IC T OR DIVISION 8. NET CON TENTS Q NOT APPLIC ABLE C D not d e ter m in ed U N I TS E X AMI N ED 10. S U M M A R Y O F A N A L Y S IS DECLARED/UNIT. AMOUNT FOUND % OF DECLARED . ? .. A fj. 9. LABEL ING C D O Rl GI N A L(S> S U B M I T T E D j | _____________________ C O P I E S S U B M I T T E D | | NONE / / .? - C / '/r C 11. R E S E R V E S A M P L E 12. D A T E REPORTED 13a. A N A L Y S T fa ; NAME 15. PROGRAM D A T A P MS NO. PROBLEM OP E R A T I ON H I A / D C C NO A C T I VI TY NO. OF -OTS FD FORM 431 (5/73) P R E V I O U S E D I T I O N IS O B S O L E T E . 13b. NUMBER 13c. PC 14. METHOD/ CACULA- TION i CHECK b. DATE M E T H O D (C h eck no more then two) (A) Q ] MAC ROSCOPI C (M) I T l M I C R O S C O P I C (X) X-RAY (F) l I F I E L D EXAM (P) [ 3 PHY EXAM (B ) 23 B A C T (O) I )p RG AN CD(C ) CHEM (N ) w / O A N A L ( L ) BIO PAGE O F PAGES. ANALYST WORK SH EET 3. S E A L S IN T A C T I 1BROKEN I I NONE 7. D E S C R IP TIO N OF S A M P LE --T7 /> x - ip L ------------- 1. P R O D U C T 7n 4. D A T E R E C D L-- 5. R E C E IV E D FR O M ?/ / S A M K L t NUHtJtM 6. D IS T R IC T OR D IV I C- 8. NET CON- TENTS | | NOT APPLI CABLE j NOT DETERMINED UNITS EXAMINED 10. S U M M A R Y O F A N A L Y S IS D E C L A RE D /U NI T AMOUNT FOUND % OF DECLARED r, /' *2 . / , 9. LABEL- ING Q ORIGINAL(S) SUBMITTED I I _______________________ C O P I E S SU B M I " I I NONE o :( / i /` - / 1 1. R E S E R V E S A M P L E 12. D A T E REPORTED 13a. A N A LY S T / ) NAME is. P r o g r a m d a t a ,PM5 NO. PROBLEM o p e r a t io n HI A/ DCC NO A C T I VI TY NO. OF OTS 13b. NUMBER 13c. PC 14. METHOD/ CACULA- TION i CHECK b. DATE M E T H O D ( C h eck no m ore than two) (A) ( M A C R O S C O P I C (M) Q T ] M I C R O (X) X r R A Y (F) | | FI E L D E X A M (P) P H Y E X A M f B J ] B A C T (O) [ (C) C H E M (N) W / O A N A L (L ANALYST WORK SHEET 3. S E A L S [_J I N T A C T [^B R O K EN ( NONE 7. D ESC R IPTIO N OF S A M P LE T "^ / c f&! &{- 4. D A T E R E C D 5. R E C E IV E D FROM , .A S ' y /> 7 o /c . . J PI. jf i/ / ~ /5> > A J T 72- r / 7 7 *r~~ / y t j - j :>< %/ r.f.9i J 6. D IS T R IC T OR D IV Ii J4t S S C . .. '8. NET CON TENTS 1\ N O T A P P L I C A B L E I I NOT DETERMINED U N I TS E X AMI N ED 10. S U M M A R Y O F A N A L Y S IS DECLA RED/UNI T AMOUN T FOUND %O F D E C L A R E D 9. LABEL ING 1 1 OR I GI N A L( S) SU BMI T T E D 11 1`C O P I E S SU B M 11 N O N E / ', c >7OS)' C o 3' ( /' ' c; ,/ / /' / 1. /" *. /' O *7 / / 11. R E S E R V E S A M P L E 12. D A T E REPORTED 7 . -v 13 e . A N A L Y S T ^ ; N A M E w 5. PROGRAM D A T A jP M S NO., PROBUEM OPERATION a / dcc n o . 3; 13b. NUM BER 13c. PC 14. 1 METHOD/ CACULATION j CHECK A C Tl VI T Y NO. OF OTS ---------- L ~ HOURS M E T H O D (C h e ck no m o re than two) (A ) m ac r o s c o p ic (m) n ^ r g r r c R o (X ) x . - R A Y (F ) F I E L D E X A M (P ) Q P H Y E X A M f B j Q B A C T (O) [ ( C ) C H E M (TV) Q W / O A N A L ( L