Document Eq1b41GZ74bxxE51NX8kGnnvg

ANALYST WORK SHEET 3. S E A L S I 1 IN TA C T Q J b ROKEN I I NONE 7. D E S C R IP TIO N OF S A M P L E 1. P R O D U C T 4. D A T E R E C D ` > 5. R E C E IV E D PROM / t- r L 7 c> i/y . 2. S A M P L E N U M B E R 6. D I S T R I C T OR DI VISION 8. NET CON TENTS I 1NOT A P P L I C A B L E NOT DETERMINED UNI TS E X A M I N ED 10. S U M M A R Y O F A N A L Y S I S DECLARED/UNIT. AMOUNT FOUND % OF DECLA RED . 9. LABEL ING ORIGINAUS) SUBMITTED | | _____________________ C O P I E S S U B M I T T E D | | NONE s~ u / 1. J ( 7 . ' l - XI < //C o > / / /o ho Lf-hO/! f, i / ///u l // i k c f j c > r i - f ,. C1 t / * - n / v / - C - s o # L y L b Ai 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 fs ; NAME *1 /` 15. P R O G R A M D A T A PM S NO. t. PROBLEM OP ERA TION HI A/ DCC NO A C T I V I TY NO. 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. NU M BER 1 3 c . PC 14. METHOD/ CACULA- TION ! CHECK b. D A TE M E T H O D (C h e c k no m ore th e n tw o ) (A ) M A C R O S C O P I C (M ) | | M I C R O S C O P I C (X ) X . - R A Y ( F) | | FI E L D E X A M (P ) PHY EX AM f B j Q B A C T (O ) j |p R GAN (C ) CHEM (N ) w / O A N A L (L ) BIO PAGE O F PAGES,  "] B R O K E N nome 7. D E S C R I P T I O N O F S A M P L E LI P - VJx , , y U--- * ..--,-- /* * r ... / , v* / y / .- / io. U IO 1 N I C I U K D I V I S I O N / t W st . * ' 8. NET CON- TENTS (..... i N C r A P P I . I C A B L F 1 1NOT nr.TERMIUF: O ' UNI TS K X AMI N Ft* 10. S U M M A R Y O F A N A L Y S I S /O ( ~ j n F c l a b r; n A M O U N T F ' >L` r ! > % o f:> r < i T L . A K r ' v ______________ ___________ ___ 1, | L A0 C LINC i \ mmt i -, r mm, itr , ,___ r . ] O R I G I N A l _ t S) SU BMI T T E D 1 CO PI ES SU BMI T T E D N O N E. .J U - : ;/ j /; / y . * * V. , . C / ' / /' / / C fi'- / * '/ h / Y . . ; v - ' .-x / / V / V,,H , . ;i I. /^ / -- /. .; `V / LV (/ , - - /-^ V - r ^ J/' V - < / , / * / tr< /V , / '/ ' / ' r . / / / 'F A U / ' ,.7 / ,p / . < / /" Y t' f . ' / / J /: .! / < , ' / Ci- / /- ' , y #.. // / 1 t . R E S E R V E S A M P L Et /X y. \ ; , c r i'i'f / ,-L . 12. D A T E REPORTED fy / j/ 13a. AN A L Y S T f a ; N A M E - /' * ,.' 13b. NUMBER 13c. P C 14. CALCULA- TIONS CHECKED a. BY b. D A T E 15. P R O G R A M D A T A MS, N PROBLEM O PER ATIO N H IA / D C C NO. AC TIVITY NO. ,O T S HOURS FD FORM 431 (8/7 2 ) P R E V I O U S E D I T I O N IS O B S O L E T E ; . M E T H O D (C h e c k no m ore than tw o ) (A) [ ' ] M A C R O S C O P I C (M) | 1 M I C R O S C O P I C (X ) (P) ( X jX r R A Y (F) | | H E L D EXAM PHY EXAM ( B ) O b a C T (O,) d | 0 R G AN (C ) [ C H EM (N ) O w / o A N A L (L ) BIO GPO 934-261  b r o k e n _____________ C l n o n e 7. D E S C R I P T I O N OF S A M P L E I fP /, ' y '.u / / / | / /,y . - . . . . - ;* ! ,D. U P I M I U I U K D I V I S I O N i \//f / ' 2 ' } / " 8. NET CON- TENTS j " | N 1. r A P P L I C A B L F 1" N O T D E T E R M I N E O r U N I T S E X AlvHN )' L' 10. S U M M A R Y O F A N A L Y S I S C l PEL LA REP A M O U N T f ' l i C % or - - r . r c l. a k r n ______________________ 9. LA D E L ING i ' ] O RI GI N A L I S) S U B M I T T E D i H COPIES SUBMITTED [ ~"\ NONE. J U} *' 5- /v ' / / Vv -1 J s (J/f ' / */ c /4 v : - ,A : / / " ' ; *, / ; / <-,, - L- , - j c-JC / (j tr* A's c Pr ;/ x -r' V ' -V, * .//. /. y.' ' . V>V ,,V Z * V (. / , l > V / / ' / / P// 1C t f /'>( :'>( f` '<' -- /C.L P',- / / /'" 12. D A T E REPORTED y 13a. AN A L Y S T f o ) NAME _/ , 13b. NU M B E R 13c. PC 14. CALCULA- T IO N S CHECKED a. BY b. D A T E 15. P R O G R A M D A T A JEMS, NtL. _P3 _ S S L E M OP EH A T I O N H IA / D C C NO, A T T I V I TY NO. LOTS FD FORM 431 (8/72) P R E V I O U S E D I T I O N IS O B S O L E T E . M E T H O D ( C h e ck no m ore then tw o ) (A ) [ ' ] M A C R O S C O P I C (M ) C J Ml c R O S C O p l C (X) C j X,,RAY fFJ F IE L D E X A M <p) c . l P H Y e x a m ('b ; C 3 b a c t < ) O 0 R G A N ( C ) [ C ) C H E M (TV) C l W / A N A L ( L ) B l GPO 934-261 * :' - c L < ***- . c ' * * % - ' ' . .. - v # . -fr t I W r f t f *~t V i - l i .. . ANALYST WORK SHEET 3. S E A L S [ p '7 i n t a c t f" '] b r o k e n LH none 7 D E S C R I P T I O N OF S A MF ' L E / / t O} 4. D A T E R E C O ,/ * ' ____ 7 1 ' ' ' 5. R E C E I V E D F R O M r r t* i; ' W /> /6. D I S T R I C T OR DIV ISION : ) NO T A P P L I ( At L F F" | H O T P F T F. K V I ' I E f> | | U N I T S F \ Af 1M I"") 10. S U M M A R Y O F A N A L Y S I S OF. I . % ! O AMOI* NT FTI;N 7 F- P F C i. A U -. D / / V - . . ; - .7 Cn M ,., / 77 ; *- (t / , ' / < O ,- / / V ( W , ., /; 7> 7 j r u/>)' >f1/. i' Z i* M >..r / / ' a/ - 7 7 / 7 x \//; d / ` ' (st V / 7, / / t 'i / 7 /c Q 7 r u a 7 1'-A. o /.(? / \ f . C / a / LA 7 . l ` >1 O H' <MN A M S ) SU BMI T 1 E P r j _____ C O F 'I E S SU BMI T T E D [ ] n o : I r. v <? f * " ,- V .y I 1. R E S E R V E S A M P L E ------ ------------------- i.' t r . . l sC L.i ----i L i / i j 12. D A T E REPORTED ,y / c - 6 /V 13a. A N A L Y S T f s ) NA ME 13b. N U M BER 14. CALCULATIONS CHECKED e. BY b. D A T E 15. P R O G R A M D A T A JiMSJxQ. I. ______p r o b l e m OP E R A TION HI A/ D CC MO ACTIVITY I <o. or T 'fs ___ h o u r ; FD FORM 431 (8/72) P R E V I O U S E D I T I O N IS O B S O L E T E . M E T H O D ( C h e c k no more than two) (A) f " | MACROSCOPIC (M) C ] m i c r o s c o p i c ( X ) Ll J x . R A Y ( F ) | 1 F I E L D E X A M (P) [ " j P H Y E X A M ( B ) d ] B A C T CO) I [ o R G A N (C ) d J C H E M (N) CTIW/O A N A L (L ) d ] BIO G P 0 9 3 4 - 2 61 VT >;?$**# I ' .**>** s + y l - ^ .iapji.^ W A .wv u w 'jfl'm n w ,v m r.* *r 1------------- '.................. ........................................ " 'u 1 . P R O D U C T A N A LY S T W ORK SH EET 3. S E A L S INTACT [ 'B R O K E N NONE T a /p u . 4. D A T E RE C O S. R E C E I V E D F R O M - At , . . / y /M f v ;,K . 7. D E S C R IP T IO N O F S A M P L E 2. S A M P L E N U M B E R 6. D IS T R IC T OR DIVISION -- ................... ' ^ ........... ' ' 1- y r / " t r a i t i r ; : 1 : / / `7 . / y/ ' ' / ' _ . "/ / i s: \ . Z : y j j f " J " ' c: . ;/ / A c , /. i . r ;y > .8. NET CON TENTS NOT APPLICABLE n o t d eter m in ed u n it s ex a m in ed I I DECLARED AMOUNT FOUND. % O F D E C L A R E D __ 9c La bel in g Q ORIGINALtS) SU BM ITTED j | __________________________ _ C O P ! E S S U B M I T T E D I | NONE 10, S U M M A R Y O F A N A L Y S IS /: / 'f c7 (' .. ' tv y /, c 11. RESERVE SAMPLE 12. D A T E REPORTED 13a, A N A L Y S T (a) NAM E ./ ill 13b. N U M BER 13c. P C 14. CALCULA TIONS CHECKED 15, PROGRAM D A T A . FD FORM 431 (8/72) OP E R A T I O N H I A / D C C NO A C T I VI TY NO. OF ,OTS HOURS P R E V I O U S E D I T I O N IS O B S O L E T E M E T H O D (C h e c k no m ore th a n tw o ) (A ) M A C R O S C O P I C (M ) m i c r o s c o p i c (X ) XfRAY (F) FIELD EXAM (P ) PHY EXAM (B ) B A C T (O ) I |o R GAN (C ) CHEM (N) w / O A N A L (L ) BIO GPO 934-261 A N A LY S T W ORK SH E ET 3. SE ALS INTACT , BROKEN n NONE 7 . D E S C R IP T IO N OF S A M P L E 1. P R O D U C T . /g . . 4. DATE RECD s ' ' y y a '/ . ` * . - / - 5. R E C E IV E D FROM / \ ' / U .Y -- - 7 \ i h r , c. 2. S A M P L E N U M B E R 6. D IS T R IC T OR DIVISION IS. NET CON TENTS Q NOT APPLICABLE [ I NOT DETERMINED {3 ) UNITS EXAMINED to , SUMMARY OF A N A LY S IS | | D E C L A R E D _______ AMOUNT FOUND, % OF DECLARED . s. La b e l in g | 1ORIGINALlS) SU BM ITTED | | ____________________________C O P I E S S U B M I T T E D | | NONE 11. R E S E R V E S A M PLE 12. D A T E REPORTED 13a. ANALYST^; NAME 13b. NUMBER 13c. PC 14. CALCULA TIONS CHECKED b. D A T E 15, PROGRAM D A T A JEMS. E 3 P .B IS M OP E R A T I O N A / D C C NO A C T I VI T Y NO. OF OTS FD FORM 431 (8/72) P R E V I O U S E D I T I O N IS O B S O L E T E . M E T H O D ( C h e c k no more then tw o) (A ) [ ^ M A C R O S C O P I C (M) [ [ ] M I C R O S C O P I C (X ) X , R A Y (F ) | | FI E L D E X A M (P) [ ] P H Y EXAM f B j Q B A C T ( 0 ) I ORGAN ( C ) [ [ |3 C H E M (TV) d ] W / 0 A N A L ( L ) [ [ [ ] B I O GPO 934-261 ANALYST WORK SHEET 3. S E A L S 1 1IN T A C T 1 1BROKEN Q 3 NONE 7. D E S C R I P T I O N OP S A M P L E 1. P R O D U C T / &. C. f^CtJcyf/ 4. D A T E R E C D 5. R E C E I V E D P R OM ^ ((C AZ \ A -t t LJi ' . * / A ' "T ~ 3-- y s J/ A .A _ / i J i if . 2. S A M P L E N U M B E R 6. D IS T R IC T OR DIVISION / s / \ ' <: \ A J 18. ( N O T A P P L I C A B L E NET CON 1 NOT DETERM IN ED TENTS U N I T S E X AMI N E D 10. S U M M A R Y O P A N A L Y S I S D ECLA RED/UN IT AMOUNT FOUND % OF DECLARED 9. LABEL ING Q ORIGINALlSl SU BM ITTED CO PIES SUBM ITTED | |NONE / Ja/ c 3 3. 3. C a r ^ C h . c\ 7 7 * -- / f iA / r C -c < ,-v) / t 0 -< ? /~ f / , .- r 'C c /. / - / h 'Cin <? / / ' f i - r~ c If / 4 f t/r^ : / 7 7 A *: a ? sx / y ( // c/^S o / < /<: 7 , />/// Cf ' k - n O / '/' .} ? f c /( / 7 11 / h n /y ? /r / , Y 'A / . C / "/% t . c? f % 0 / f ' #t / f -' { ' g / /3 / ' // .- ' f t d ) '\ J / s/ i //'c oS S- ? o / a 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 fs ; NAME iA ' 15. P R O G R A M D A T A P M S NO. PROBLEM LA OP ERA TION H I A / D C C NO. A C TI VI T Y NO. OF UP.T.s 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 . /I 3b. N U M B E R 13c. P C 14. METHOD/ CACULA- TION i CHECK b. D A T E M E T H O D (C h e c k no m ore th e n tw o ) ( A ) Q M A C R O S C O P I C (M ) \ A \ Ml C R O S C O P I C ( X ) Q X - ' R A Y ( F ) | | FI E L D E X A M (P ) PHY EXAM r B ; Q b A C T (O ) | O R G A N (C ) CHEM (N ) W / O A N A L (L ) BIO PAGE O F PAGES. 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 . PAGE O F PAGES.