Document Lgx4O1N5dDaV440w6y8qDjQ9w

j ANALYST WORK SHEET 3. S E A L S in t a c t 03 bro ken n none 7. D E S C R I P T I O N O F S A M P L E T product" " X -S -X X 4. D A T E R E C O , / I v j a-H i. - y 5. R E C E I V E D F R O M /" i 4 jz GG 2. S A M P L E N U M B E R 6. D I S T R I C T O R D I V I S I O N 7 y< x ^ c - t / ' x ' 7 ; ... '/ . '' A /* ...................... N l H . I W t l -- .. .H, ....... . ... -........ ........ ------ . -- ---- ------------------ ---------- ----- -- -------------------------------------------------- ----- -- ----- 8. . Q not APPUCASUE NET CON Q ] NOT DETERMINED T ENTS [^] units examined v_^-~ to. SUM M ARY O F A N A L Y S IS 1 I d ec lared , amount found. %of d ecla red , CX A - U ' c O ' I v - <- 3, ' > ; ' .* / L' f . r r zr> `/ - c /*) y / >' l } / 7 /'* j t *7 " / / c s*i ,ri 9. LABEL; 1NG ORIGINAL(S) SUBMITTED ______________ COPIES SUBMITTED | | NONE <c_ /. / 7 / r< av, ' 7 7 c 7 / G /> a r / `c` Z 7 vT ~ /' ' V ti. 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 f e ; N A M E J * % r . V 15. P R O G R A M D A T A E B P JjAAM (y OP E R A TION H IA /D C C NO. 13b. N U M B E R 13c r p c j ' u . |C AA L C U L A T "T IO N S 1 rC' uH E C K E D b. D A T E A CTI VI TY NO. O-TS HOURS METHOD (C h e ck no more than two) (A ) Q M A C R O S C O P I C (M) [7Xm \ C R O S C O P I C (X ) X . - R A Y (F) 1 | FI E L D EXAM (P) Q PHY EXAM fjB,) B A C T (O ) I |p RGAN ( C ) [21] CHEM (TV) Q w / O A N A L ( L ) BIO 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 . GPO 934-261 ANALYST WORK SHEET 3. S E A L S I I INTACT p~1 BROKEN I INONE 7. D E S C R I P T I O N O F S A M P L E 1. P R O D U C T /t i 4. D A T E R E C D // 5. R E C E I V E D P R O M ..'A. f ' !y 2, S A M P L E N U M B E R 6. D I S T R I C T O R D I V I S I O N 8. NET CON- TENTS NOT A P P L I C A B L E | | NOT DETERMINED | | UNITS EXAMINED 10. S U M M A R Y O F A N A L Y S I S 1^ \ $ Q ] DECLARED AMOUNT FOUND. % O F D E C L A R E D ______ C/ s / z "iA-C o / // >- O > , 'T '/ V. ' // / f t . ( / / /yT /? >7 / O * '' . ' I . /> <=* , & 9, j LABEL- i ING [ | ORIGINAUS) SUBMITTED j-- j COPIES SUBMITTED I INONE 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 ^ ; N A M E _ 13b. N U M B E R - r 13c. P C 14. CALCULA TIONS CHECKED IS. PROGRAM DATA MS, PR&J.-E-M OP ERA TlON H I A / D C C NO. A C T I VI T Y NO. OF -OTS H0 UR5 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 . METHOD (C heck no more than two) (A) Q ] MACROSCOPIC (M) MICROSCOPIC (X ) g ] XRAY (F) F I E L D EXAM (P) [ ] P H Y EXAM ( ^ B A C T (O ) | |ORG AN (C) n CHEM (N) w / O ANAL (L ) BIO GPO 934*26! ANALYST WORK SHEET 3. S E A L S 1___j INTAC T Q ] BROKEN 1 1NONE 7. D E S C R I P T I O N O F 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 I V E D F R O M _/___? I-/---:*----r----"----. (/ 2, S A M P L E N U M B E R 6. D I S T R IC T OR DIVISION 8. NET CON TENTS | 1NOT A P P L I C A B L E NOT DETERMINED UNITS EXAMINED 10. S U M M A R Y O F A N A L Y S I S I I DECLARED. AMOUNT FOUND, f, O F D E C L A R E D ____ i) o A- 3 V. < - . t *7 -.'S /l o, ^ & --f >/.f',/ .c />:. & py / < / i ' y 9. j LABEL ING 1 I ORI GINA U S ) _______ I I NONE SUBMITTED COPIES SUBMITTED / ' - 4 ^ 0 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 f e ; N A M E 13b. N U M B E R 13c. P C 14. CALCULA TIONS CHECKED b. DATE 15. P R O G R A M D A T A m ES.gB.kEM OP ERA TION H I A / D C C NO A C TI VI TY NO. OF 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 . METHOD (C heck no more then two) (A) MACROSCOPIC (M) | | Ml C ROSCOPI C (X) Q X i R A Y (F ) I I F IE L D EXAM (P) [ ] PHY EXAM (B ) [^3 B A C T (O) | ORGAN (C) CHEM (N) Q w / O ANAL (L ) BIO GP 0 9 34-26 t I A N A LY ST WORK SH EET 3. S E A L S INTAC T J BROKEN 1 1NONE 7. D E S C R I P T I O N O F S A M P L E 1. P R O D U C T 4. D A T E R E C D ,, U . . '1 5. R E C E I V E D F R O M rT A M p C T N U M BET 6. D I S T R I C T OR D I V I S I O N | | NOT A P P L I C A B L E N O T DETERMINED U N I T S EXAMINED 10. S U M M A R Y O F A N A L Y S I S 7 "k /C '/> /! VI n * A t <' n I I DECLARED. AMOUNT FO U N D , % OF D E C L A R E D _____ / > "9. ! Q O R I G I N A U S ) S U B M IT T E D L A B E L - j ING _______ C O P I E S SU BMI T T ED I I N ONE //, 7 / / / : < / : >7 7 / / 'i 1). R E S E R V E S A M P L E 12. D A T E REPORTED - 7 ,/ 7 i f ' 1- / 13c. A N A L Y S T f c ; NAM E _13b. NUM BER 13c. PC il4. CALCULA TIONS CHECKED a. BY b. D A T E 15. P R O G R A M D A T A PROBLEM OP E RA TION A / D C C NO AC TI V! TY NO. OF LOTS HOURS 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 heck no more than two) (A) M A C R O S C O P IC (M) M I C R O S C O P I C ( X ) X . . R A Y (F ) | | FI E L D EXAM (P ) PHY EXAM (B ) B ACT ( O ) | ORGAN (C ) CHEM (N ) Q w / O ANAL (L ) I I BIO GP 0 9 3 4 -2 6 ! i A N A LY ST WORK S H EET 3. S E A L S j__ ( I N T A C T BROKEN 1 1N O NE 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 4. D A T E R E C D 5. R E C E I V E D F R O M / / 2. S A M P L E N U M B E R ,6. D I S T R I C T OR D I V I S I O N ^ 8. NET CON TENTS NOT A P P L I C A B L E | 1NOT D E T E R M I N E D | | UNI TS E X A M I N E D 10. S U M M A R Y O F A N A L Y S I S | | D E C L A R E D , . ______ AMOUNT FOUND. % OF D E C L A R E D ____ T9. S i l O R IG I N A I . ( S ) S U B M IT T E D L A B E L - j ING _______ COPIES SUBMITTED I I NONE v. ) , /// * o, >,r/-' 'S 1 . ^ r/ / / "V / i ' -r( //: 1 1. R E S E R V E S A M P L E 12. D A T E REPORTED <;'fi ~~ ` ' ' //.** - 13a. AN A L Y S T ( e ) N A M E /,/ L / 13b. NUMBER ;13c . P C f t . CALCULA TIONS CHECKED b. D A T E 15. P R O G R A M D A T A fJbl J L FD FORM 431 (8/72) OP E RA TION H IA / D C C NO. ACTI 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 . METHOD (C h e ck no more than two) (A) MACROSCOPIC (M) | l Ml CROSCOPI C (X) X.RAY (F ) | | FIELD EXAM (P) PHY EXAM C B J Q b ACT ( O ) | ]p R GAN (C ) CHEM (N) Q W / O ANAL ( L ) BIO GPO 934-26 ANALYST WORK SHEET 3. S E A L S 1____1I N T A C T Q 3 BROKEN 1 1N O NE 7. D E S C R I P T I O N OF S A M P L E t \ 1. P R O D U C T llii !> 4. D A T E R E C D ,( / / 5. R E C E I V E D F R O M /'" . y, jo / y w 'i / 2. S A M P L E N U M B E R 6. D I S T R I C T OR D I V I S I O N 1 8. NET CON TENTS | | NOT A P P L I C A B L E | NOT D E T E R M I N E D | | UNITS EXAMINED 10. S U M M A R Y O F A N A L Y S I S | | DECLARED AMOUNT FOUND 7. OF D E C L A R E D -. 6 ? 7 i f / o t 0-cY / <-t - 9. LABEL ING O Rl GIN AL( S) S U B M I T T E D r| COPIES SUBMITTED | | NONE " < ' ' ,v v. ' . > vy 1 ; f/c n t V' Y_ ' > ,-* / : c. '* i r ./ - //V. / / * /'/ iff SeSi. . -- 5 v ' . / / - t.- / / A - ^/ - * , / \y 5 c7 / v t f / t-. . r vj: 11. R E S E R V E S A M P L E 12. D A T E REPO RTED /J vT-'- / 7/ / 15. p r o g r a m d a t a .PMS, NPik FD FORM 431 (8/72) 13a. A N A L Y S T (e_) N A M E / _ / / / / // . * 13b. N U M B E R 13c. P C 14. CALCULA TIO NS CHECKED a. BY b. DATE OPERATION H I A / D C C NO ACTIVITY NO. OF LOTS 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 . (A) |~| MACROSCOPIC (M) | | Ml CROSCOPI c (X ) Q X / R A Y (F) 1 I F IE L D EXAM (P) PHY EXAM f B j Q B A C T ( O) | ORGAN (C ) CHEM (N) W / O ANAL (L ) BIO GPO 934-26 ANALYST WORK SHEET 3. S E A L S 1___) I N T A C T 11--] B R O K E N 1 1NONE 7. D E S C R I P T I O 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 '7 ""4 v , 5. R E C E I V E D F R O M 7 / c* (/ `T ~ // 2. S A M P L E N U M B E R 6. D I S T R I C T OR D IV IS IO N 8. ! NET ; CON TENTS I [NOT A P PL IC A B L E | [NOT DETERMINED [ UNITS EXAMINED 10. S U M M A R Y O F A N A L Y S I S | | DECLARED AMOUNT FOUND % OF DEC LA RED 3 3o , '/ . a / c . < v< ,1 LABEL ING Q ORI6INA1.1S) S U B M I T T E D 11 CO PI ES SU BMI T T E D 1 1NONE ;v ^ c - . 6r , , .- ^ // " 7 T r . c / /? `: ; /' / - V < / c- i- i f <. ^ v . " cv /C 11. R E S E R V E S A M P L E 12. D A T E REPO RTED C - " / / . y' / '/ 15. P R O G R A M D A T A -PMS NO. 1. 2. P 8 5P Si FD FORM 431 (8/72) 13a. A N A L Y S T ('eJ N A M E ; OPERATION h ia /dcc no . j/ ' ./ ,, r/ - 13b. N U M B E R 13c. P C 14. CALCULA TIO NS CHECKED a . BY b. DATE ACTIVITY NO. OF LQ*S HOURS METHOD (C h eck no more then two) (A) M A C R O S C O P IC (M) MICROSCOPIC (X) X . R A Y (F) | | FIEL D EXAM (P) P H Y EXAM ( B ) B ACT (O ) | | p R G AN (C ) CHEM (N) w / O ANAL (L ) BIO P R E V I O U S E D I T I O N IS O B S O L E T E . GP 0 934-261 ANALYSTWORK SHEET 3. S E A L S rn B R O K EN j INTACT CDNONE 7. D E S C R IP T IO N O F S A M P L E 1. P R O D U C T , / - 9 /9 4. D A T E R E C D S. R E C E I V E D FROM v v ./ A A #*3 2. S A M P L E N U M B E R 6. D I S T R I C T OR D IV IS IO N / / '/ A V / NET CON* TEN TS | j NOT A P P L I C A B L E NOT DET ERM INED Q u n it s e x a m in ed 10. S U M M A R Y O F A N A L Y S IS I I DECLARED, AMOUNT FOUND. O F D E C L A R E D _ ___ La bel in g ORI GINAL(S) S U B M I T T E D [ | _______________ COPIES SUBMITTED I j N ON E .9 /9 ). c / J (, / , i s ' ? A A-. J /'', /- / 'S f`5 C C- A '/ ' - / / 5 /. / .......A * /t A , '/ V "A 11. R E S E R V E S A M P L E / / Ai A 9 / 7 12. D A T E REPO RTED 9 ,/ r ?A 13a. A N A L Y S T ^ N A M E // 1,3b. N U M B E R 13c. P C 14. CALCULA TIONS CHECKED IS, PROGRAM DATA -MR* iS L E M OPERATION H IA / D C C NO ACTIVITY NoOr. LOTS HOURS 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 . METHOD (C h eck no more then two) (A) Q MACROSCOPIC (M) ^ ' M I C R O S C O P I C ( X ) X.-RA Y (F) [ ^ ] F I E L D EXAM (P) p h y e x a m ^ b a c t r o ; D RGAN ( C ) CHEM (N) Q w/O A N A L ( L ) BIO GPO 934-261 1. P R O D U C T ANALYST WORK SHEET t . SEALS in t a c t 0 BROKEN I I NONE 7. D E S C R I P T I O N O F S A M P L E [4. D A T E R E C D S. R E C E I V E D FROM 2. S A M P L E N U M B E R sf- 6. D I S T R I C T OR D IV IS IO N 'r 7 8. NET CON TENTS n o t A PPLIC A BLE n o t DETERMINED Q UNITS EXAMINED to. S U M M A R Y O F A N A L Y S IS | | DECLARED AMOUNT FOUND, % O F D E C L A R E D _____ 9. La bel in g Q OR1G1NALIS) S U B M I T T E D | | ________________________ C O P I E S S U B M I T T E D | 1NONE .7 3/^ L ; . 'C J ' c // y ^ ''' /. // ,, ( f/js ? J / ) C O /"* / 5 J s / . .- 0 V7 11. R E S E R V E S A M P L E y<.y I/f . u / S '. , c ,, 12. D A T E REPO RTED Z y- '?/.j 13a. A N A L Y S T (e) N A M E ' < '/ / / 1,3b. N U M B E R / / ' , ' - . i f 13c. P C 14. CALCULA TIONS CHECKED 8. BY b. DATE 15, P R O G R A M D A T A M5. fR&LE.M OPERATION n h ia / dcc no A C T I V I TY NO. OF OTS HOURS 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 . METHOD (C h e c k no more than two) (A) [MACROSCOPIC (M) ^ M I C R O S C O P I C ( X ) jX . - R A Y ( F ) [ | FI E L D EXAM (P) PHY EXAM (B ) ] BA C T (O) [ |p RG AN (C) ( CHEM (N) O W / O ANAL (L ) [ BIO GTO 93 4-261 ANALYST WORK SHEET 3. S E A L S I I INTACT ^ ''B R O K E N PH NONE ?7 D ESC RIPT IO N OF SA M PLE 1. P R O D U C T J j O t y O i / t T T T z a / s s ' ' 7 * ^ 7 0 aT d a t I T r e c d sT R E C E IV E D FROM 2. S A M P L E N U M B E R ,6. D I S T R I C T O R D I V I S I O N A P /u M ' P co< A - fP e. [ N O T A P P L I C A B L E N ET CON ( 1NOT D E T E R M I N E D _^T E N T S Q | UNITS EXAMINED , - -- 10. S U M M A R Y O F A N A L Y S IS j I DECLARED . AMOUNT FOUND - - '.i....O...F....D.. E C LA - R ED ... .. - - . 9. La bel in g 1 1O R I G I N A U S ) S U B M I T T E D 11 CO PI ES SU BMI T T ED 1 1N O N E - .... -- ... - - - - / 7*/c 0 - 7 7 / ) 2 L- / A o z % -Ay--/7 3. 0 7 iP % Y /es/?a 'P A / 7 / c y? 3 cTat A / -? 0 7/// '\,,G*yt .'Sc /Ay/Asdh*os 7 7/ y .</P>\A/C' 3 C- ->/o OOtS' /PM> -/ 7 A / C A / / / O.-dZ' U / Ce / / a s 7 / '' & - < 2 L 11. R E S E R V E S A M P L E 12. D A T E REPO RTED 'Y /7# " 13a. A N A L Y s W 7 ^ - n AME / ^ / 7 _7 c a a / a /z a ? _ (3b. N UM BER >13c. P C 14. CALCULA TIONS CHECKED b. D A T E 15. P R O G R A M D A T A PR OB LEY O PE RA T IO N H I A / P C C NO ACTI VITY NO. OF .O TS HOURS 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 . METHOD ( C h e c k no more th a n tw o ) (A) M A C R O S C O P IC (M) Q M I CROS COPI c (X ) X . . R A Y (F ) I I FI E L D EXAM (P) [ P H Y EXAM f f i ) Q B A C T CO) I |ORGAN (C ) CHEM (N ) V V / O A NAL (L ) BIO GPO 934-26! ANALYST WORK SHEET 3. S E A L S F T INTACT [ 'BR O K EN Q NONE 7. D E S C R IP T IO N O F S A M P L E 1. P R O D U C T f J,. 4, D A T E R E C D 5. R E C E I V E D F R O M T~` 2. S A M P L E N U M B E R / - 6. D I S T R I C T O R D I V I S I O N BUW AM KM i >e. NET CON" TEN TS P I NOT A P P L I C A B L E J ^ ] n o t d eter m in ed UNITS EXAMINED Ignefc--fiMi 10. S U M M A R Y O F A N A L Y S IS I I DECLARED AMOUNT FOUND. % OF D E C L A R E D .. << So j La bel- in g | | lOBlGINAL(S) ,-- . 1-- - -- -- ----- NONE S U B M ITTED COPIES SUBMITTED / ( // ' 11. R E S E R V E S A M P L E ft . / C 12. D A T E REPO RTED 7 13a. A N A L Y S T f s ; N A M E 13b. N U M B E R .-A . '` 7 13c. P C 14. CALCULA TIONS CHECKED 15. P R O G R A M D A T A m PROBLEM OP ERA TION TJ H A/PCCNO ACTIVITY NO. OF 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 . METHOD (C heck no more then two) (A) [ [ [ M A C R O S C O P I C (M) I ' mi C R O S C O P I C (X) XfRAY (F) [[[] F IE L D EXAM (P) [ [[P H Y EXAM (B) BA C T (O) I ORGAN (C) CHEM (N) w / O A N AL (L) I I BIO GPO 934-261 1 ANALYST WORK SHEET 3. S E A L S l _ J IN T A C T F I BROKEN C J NONE 7. D ESC R IPT IO N O F SA M PLE l. PRO D U C T; 4. D A T E R E C O 5. R E C E I V E D FR O M y / s h v v H - 2. S A M P L E N U M B e S 6. D IS T R IC T OR D IV ISIO N e. j NET 1 C O N T EN TS P lN O T APPLIC ABLE f NOT DETERMINED f | u n it s E x a m in ed 10 S U M M A R Y O F A N A L Y S IS | | DECLARED AMOUNT FOUND, % of d ec lared //' .y*' ,C 7.5 9. La belt 1NG Q ORIGINAUS) SUBMITTED || COPIES SUBMITTED I 1N O N E C *** y/w/ /t .,'.. / / / 'S', / . 7 / // , A / c As ;-- - -- / .'\a',//. / t * ( 8"- / ' '//{c / iV '/ ' (? / ' i f ' ( 1 ' A >v 11. R E S E R V E S A M P L E ./ / ( *" - ~I 12. D A T E REPO RTED -a 13. A N A LY S T ^ ; N A M E 13b. N U M B E R 13c. PC fU . CALCULA TIO NS CHECKED 15, P R O G R A M D A T A EMA, US. PROBLEM OPERATION nr a /pc c no AC TIVITY NO. OTS HOURS 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 . METHOD (C h e ck no more than two) (A) M A C R O SC O PIC (M) MICROSCOPIC ( X ) X.-RAY (F) | | FI E L D EXAM (P) PHY EXAM (B) B A C T (O) \ ORGAN (C ) CHEM (N) Q w / O ANAL ( L ) I I BIO GPO 934-261 ANALYST WORK SHEET '3. S E A L S in t a c t broken none 7. D E S C R IP T IO N O F S A M P L E 1. PR O D U C T , . 4. D A T E R E C O 5. R E C E I V E D F R O M 2. S A M P L E N U M B E R 6. D I S T R I C T O R D IV IS IO N 18NET CON TEN TS n NOT APPU I C A BLE Q not d e t e r m in e d (3) u n it s E x a m in e d 10. S U M M A R Y O F A N A L Y S I S 1 I DECLARED AMOUNT FOUND, % O F D E C L A R E D _____ (Sc [L a b e l in g I ] ORIGINAL(S) SUBMITTED | | _______________________C O P I E S S U B M I T T E D | | NONE //'// / // / ( 4/: 8 / "V-c. / e S.-CI f / i_ i if 11. R E S E R V E S A M P L E 12. D A T E REPO RTED 15. P R O G R A M D A T A FD FORM 431 (8/72) 13a. A N A L Y S T ^ ; N A M E 13b. N U M B E R 13c. PC 14. CALCULA TIO NS CHECKED b. D A T E OP E R A T I O N H IA /PC C N O ACTIVITY NO. OF .O TS P R E V I O U S E D I T I O N IS O B S O L E T E . METHOD (C h e ck no more than two) (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 EXAM (P) P H Y E X A M ( B J ^ B A C T ( Q ) | |o R GAN (C) CHEM (N) Q w / O A N A L (L) BIO GPO 934-261 KLYST WORK SHEET 3. S E A L S INTACT ( BRO KEN NONE 7. D E S C R IP T IO N O F S A M P L E 1. P R O D U C T / . r) 4. D A T E R E C D r : : ,/ . C / '' > 5. R E C E I V E D P R O M J 2 6- " t - / . . , /. : s ' f ' 2. S A M P L E N U M B E R 6. D IS T R IC T O R D IV IS IO N Q not a p p l ic a b l e n o t d e t e r m in e d ( u n it s ex a m in ed 10. S U M M A R Y O F A N A L Y S IS I | DECLARED. AMOUNT FOUND. % OF D EC LARED , / / >/l S. La bel in g | | O R I G I N A L ( S ) SU B M I T T E D [ | __________________________C O P I E S S U B M I T T E D | | NONE ^ fi ' " ' <'-~ //' / V' CtT f / ,L- f'. r C /. i's // tt. R ESER V E SAM PLE 12. D A T E REPO RTED 15, P R O G R A M D A T A PM S NO, I. P R OB L E V FD FORM 431 (8/72) rA N fL Y S T fe ; NAME' . ! /? / ------------------ // ^ 'V sjj.-'N U M B E R ):f~ 13c. P C U . CALCULA TIO NS CHECKED b. DATE OP ER A TION H I A / P C C NO ACTIVITY 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 . METHOD (C heck no more then two) (A ) m a c r o s c o p ic (M) R ^ T c r o s c o p i C (X) X y R A Y (F) FIE L D EXAM (P) ( PHY EXAM W O b A C T ( O ) | |p R GAN ( C ) CHEM (TV) Q w / O A N A L ( L ) BIO GPO 934-261 : ANALYST WORK SHEET 3. S E A L S U J INTACT Q3 BROKEN P~1 N O N E 7. D E S C R IP T IO N O F 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 I V E D P R O M S 2. S A M P L E N U M B E R ! -------6. D IS T R IC T OR D IV ISIO N (S. NET CON T EN TS Q not a p p l ic a b l e Q n o t d e t e r m in e d UNITS EXAMINED 10. S U M M A R Y O F A N A L Y S IS | j DECLARED AMOUNT FOUND, % O F D E C L A R E D ____ / 9. j I I O R I G I N A L l S ) S U B M I T T E D La bel j ^ 1NG CO PIES SUBMITTED I I N ON E 'D 5. /t .. j - 1/ , / -t" h t/t A ' .. / . ? , ( I ' j f (-- *j , /. J! ^/ f <t / * r C ,/ //' ; 11. R E S E R V E S A M P L E f 12. D A T E REPO RTED IV ' 15. P R O G R A M D A T A 13a. A N A L Y S T (a) N AM E )L:/ir J / OP ER ATIO N EM-ESL, EAkEM H a /dcc n o . "y -- 13fo. N U M B E R 7 13c. P C 14. CALCULA TIO NS CHECKED b. D A T E A C Tl VI TY NO. OF ,O TS HOURS METHOD (C h eck no more than two) (A) Q m a c r o s c o p i c (M) P ^ T c r o s c o p i C (X ) XrfiAY (F) | j FI E L D EXAM (P) (] PHY EXAM O b ACT (O) I |P RG AN (C ) P P CHEM (N ) d jW /O AN A L (L ) P H BIO 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 . GPO 934-261 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 . G P 0 934-261 ANALYST WORK SHEET 3. S E A L S [ TtNTACT H T b ROKEN f~~l N O N E 7. D E S C R IP T IO N O F S A M P L E 1. P R O D U C T JLy 4. D A T E R E C O ^ ^ J2 . SAMPLE NUMBER ^1 Zhisv/ s fy y -3 / _ i 5. R E C E I V E D FR O ffy/ |S. D I S T R I C T OR D IV ISIO N 7 7 . / / : M /?? r ^ j 3 7-^/- o ' t c 7 _ 6. NET CON TEN TS 3 not a p p l ic a b l e 33 not d e t e r m in e d 1 1u n i t s e x a m i n e d tO. S U M M A R Y O F A N A L Y S IS 1 1DECLARED 9. AMOUNT FOUND La belin g _ _________% OF DEC LA RED ..._____ _ . . _______________ _______ . | 1 O RI GIN A U S ) S U B M I T T E D | | ____________ __ C O P IE S SUBMITTED | "1 N o r V. / 7 a /c . L& 7 * Z 7- 73. C ^ z r 6 on. 7c 3 ^ so f - r ^ -c- / / i , V A -C ^ <>7 -7/ <rv .7 7' -- ......... y V 'S e ? y o - t -s , - c/ w ' /J ~ r tiy f l S y^ 7 zrc-c" / _ 7 . y - 4 / s s s 7*:--> v c ^< 11. R E S E R V E S A M P L E 12. D A T E REPO RTED /7 7 /-/- , 15. PR O G R A M D A T A PR O BLEM 13a. A N A L Y S T ^ ; N AM E -7. /: y / i/ OP E R A T IO N u A / P C C NO / /> 7 v / //-V AC TIVITY NO. OF kTS 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 . 13b. N U M B E R 13c. PCJ14, CALCULA TIO NS CHECKED b. D A T E METHOD ( C h e c k no more then two) (A) Q MACROSCOPIC (M) p t M I C R O S C O P I C ( X ) Xj RAY (F) I I FI E L D EXAM (P) PHY EXAM C B j Q j B A C T (O) \ |QRG AN ( C) CHEM (TV) CZ]w/0 A N A L ( L ) BIO GPO 934-261 r' ; ANALYST WORK SHEET 3. S E A L S Q INTACT P 'B R O K E N 1 1N O N E 7. D E S C R I P T I O N O F S A M P L E 1. P R O D U C T j 4. D A T E R E C O 5. R E C E I V E D F R O M 4 <* / ' ' , ,Jt ~ 2. S A M P L E N U M B E R f 6. D I S T R I C T O R D I V I S I O N ,6. NET CON TENTS Q n OT APPLICABLE P N O T DETERMINED r~~l u n i t s E x a m i n e d 10. S U M M A R Y O F A N A L Y S IS | | DECLARED AMOUNT FOUND. h o f d e c l a r e d . ___ s. LA BEL IN G P ] O Rl GIN A L(S) S U B M I T T E D [ | __________________ CO PIES SUBMITTED | | NONE /. 7 * //c (7 /n / c ?/ ' ' -G J ' > i ?. - * /- J " a/ /d z) , C-- #4* ia / < y/ ' y GljT ' --/7 / O 77 / -Y1C S c fi~i/-- '//^ `J P & XC S<7, 7 7 / * 'Ufi r /L~\T" ; CXr/,-.V/; 7; ' <'C 7 j , V ( ' $ / /c / : ' t y 11. R E S E R V E s a m p l e 12. D A T E REPO RTED /r^ r 13a. A N A L Y S T fa ; N A M E / 13b. N U M B E R 13c. P C 14. CALCULA TIONS CHECKED b. DATE 15, P R O G R A M D A T A (EMA-Ma -------EiLOEULbd 1. OP ERA TION n H A / D C C NO. ACTIVITY NO. OF OTS HOURS 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 . METHOD (C h e ck no more than two) (A) Q MACROSCOPIC (M) [ p MICRO S CO PI C ( X ) X iR A Y (F) | | FI E L D EXAM (P) p PHY EXAM ( B ) p B A C T ( O ) I |pRGAN (C) CHEM (N) P ]w / 0 ANAL ( L ) BIO GPO 934-261 ANALYST WORK SHEET IT sealTY rT C 7 A ~ aT ^ BROKEN n NONE 7. D ES C R IPT IO N O F SA M PLE 1. P R O D U C T J A a o ;- 4. D A T E R E C D 5. R E C E f V E D F R O M } .? ; ' -c y 2. S A M P L E N U M B E R 6. D I S T R I C T O R D I V I S I O N E. NET CON- TEN TS [ NOT APPUCABLE n o t d eter m in ed u n its exam ined DECLARED. . AMOUNT FOUND, % OF DECLARED _ 9. La bel in g tO, S U M M A R Y O F A N A L Y S IS /. 7 & c (/ "r- *,5 CV A /v O'" ' L. <"'* \ * }' ' .<< ' c 3 - y ?. y *3, A / Cr * / .. A- (_ . \T s* t-- / u y c i f * L ' 7 / t 5 C- - / */7/ 7 A t */ /w/ < A ( / J' / y& ' ' A /Y y ) C; y A 5 C>'-(P / ay * / ' / ; ^ ( O R1 GIN A L(S) S U B M I T T E D | | ____________ COPIES SUBMITTED f i NONE c*srrTr! ,* / It. R ESER V E SAM PLE 12. D A T E 1 j < -Z- / y I3e. AN A LYST^ ; NAME /y / 7 13b. N U M B E R 13c, PC 14. a. BY i /77 y/ 7 r /* 7 7~ ^ A -A CALCULATIONS t 7 ' V C H E C K E D b. D A T E t 5, P R O G R A M D A T A EM S jie , f.RPB.I-A M, i nOP E R A TION h i a /dcc no. A C TI VI TY NO, OTS HOURS FD FORM 431 (6/72) P R E V I O U S E D I T I O N IS O B S O L E T E . METHOD (C heck no more than two) (A ) M A C R O S C O P IC (M) \ ^ i Ml CROSCOPI C ( X ) | 1X f R A Y F( ) | | FI E L D E X A M (P) . P H Y E X A M f B j Q B A C T ( O ) I ]o R GA N (C) C H E M (N) w / O A N A L (L) BIO G ? 0 934-261 ANALYST WORK SHEET ; 3. S E A L S f ' 1IN T A C T f~ l eAoKEN n NONE 7. D ESC R IPT IO N O F S A M P LE 1. P R O D U C T / 4. D A T E R E C O _ r w> [5. R E C E I V E D F R O M 7 , 7 f-ri :/ T?*. + / l * / ; 2. S A M P L E N U M B E R ^*T. -o (J) 6. D IS T R IC T OR D IV IS IO N -J L / -^-7 6. NET CON TENTS O NOT APPLICABLE r INOT DETERMINED (31 UNITS EXAMINED 10. S U M M A R Y O F A N A L Y S IS [~~1 D E C L A R E D AMOUNT FOUND. % OF DECLARED La b el in g I ] ORIGINAL(S) SUBM ITTED | | ______________ COPIES SUBMITTED | | NONE / - r \1 / /C jr ,, . X ftt- i c , S /o cs / /' / - /' 'V A i ( / 7 F* L- A V v X ( <r , Xu i c ii'> /7 C7 ' A a - U `S - + & tx / / C - C ^ - y c i < j~4 c/ 11. R E S E R V E S A M P L E s/ 9 s" /v7 f ? ./ . v. / { S .fT 12. D A T E REPO RTED 15. P R O G R A M D A T A JiM iL fi* FD FORM 431 (8/72) 7 /13a. A N A L Y S T ^ ; n a m e N/ L _ T a b . N U M B E R | l 3c. P C 14. CALCULA i i U TIONS CHECKED b. D A TE OP ERA TION A / D C C NO A C T I VI T Y NO. OF OTS 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 heck no more then two) EZTMI(A ) M A C R O S C O P I C (M) CROSCOPIC ( X ) X-*R A Y (F) I I FI E L D E X A M ( P ) P H Y E X A M (B) | | B A C T CO) I | p R G AN ( C) C H E M (N) w / O A N A L (L ) BIO GPO 934-261 j ANALYST WORK SHEET 3. S E A L S 1 1INTACT [ 'BRO KEN 1 1N O N E 7. D E S C R I P T I O N O F S A M P L E 1. P R O D U C T . / V Y "' 4. D A T E R E C D .v - } vf i 1 1 1/ - C 5. R E C E I V E D F R O M >" C , ....eli* 2. S A M P L E N U M B E R ) f 6. D IS T R IC T OR D IVISION 8. NET CON TENTS NOT A P P L I C A B L E NOT D E T E R M I N E D UNITS EXAMINED 10. S U M M A R Y O F A N A L Y S I S O' Ch . f ,'< t I I DECLARED AMOUNT FOUND % O F DECLARED 9. j LABEL- j ING I 1ORI G IN AL ( S ) _______ I I NONE SUBMITTED COPIES SUBMITTED y" / - ' V /> / , - SO <. / `i f 1c - / / v c. -- "# t , 0 // C / .; * c fo . < J* . v o / / > ' ( / '>< / / f C t / y ir j f t O 9 / 11. R E S E R V E S A M P L E 12. D A T E REPO RTED 138. A N A L Y S T ^ ; N AM E / /:tf 15. P R O G R A M D A T A M S NO PROBLEM OP ER A TION H I A / D C C NO // .i i / ACTIVITY NO. OF 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 , 13b. N U M B E R 13c. P C 14. CALCULA TIO NS CHECKED b. DATE METHOD (C h e ck no more than two) (A) M A C R O S C O P IC (M) I | M I C R O S CO PI C ( X) XRAY ( F) 1 I FI E L D EXAM (P) PHY EXAM ( B) b A C T ( O ) I [ORGAN (C ) ( CHEM (N) )W / 0 ANAL ( L ) I I BIO GP 0 934-261 ANALYST WORK SHEET 3. S E A L S 1 1I N T A C T 'B R O K E N 1 1N O N E 7. D E S C R I P T I O N O F S A M P L E 1. P R O D U C T j .;, > . 4. D A T E R E C D v c'i 1 < .< .t 5. R E C E I V E D F R O M C I --V <3 / 2, S A M P L E N U M B E R 6. D IS T R IC T OR D IVISION 8. NET CON TENTS NOT A P P L I C A B L E NOT D E T E R M I N E D UNI TS E X A M I N E D 10. S U M M A R Y O F A N A L Y S I S 1 1D E C L A R E D AMOUNT FOUND V, OF D E C L A R E D v ? /. A- ,! L A B E L - I ING _______ I I NONE C O P I E S SU BMI T TED Ch n / : 0r \ / 1I C -}*' V , r ' .' '/ '/ < / - /A / / V V <yCf i , - ? //? /CL ' / ' 11. R E S E R V E S A M P L E 12. D A T E REPO RTED ii ur~: 13a. A N A LY STfs^ ) N AM E u 13b. N U M B E R J , . . yr*--1 ' V Y * 7 13c. PC 14. CALCULA TIO NS CHECKED b. DATE 15. P R O G R A M D A T A MS, EafiAkLM. OP E R A TION HIA/OCC NO ACTI VI TY NO. ,OTS HOURS 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 . METHOD ( C h e c k no m ore th a n two ) (A) M A C R O SC O PIC (M) M I C R O S C O P I C (X) x R A Y (F) FIELD E X A M (P) PHY E X A M ( " B J Q b A C T (Q) I ORGAN (C) C H E M (N) Q W / O A N A L I( L ) I B I O GPO 934*261 -- 1 .......................... ; ANALYST WORK SHEET 3. S E A L S 1___1INTAC T BROKEN I 1N O N E 7. D E S C R IP T IO N OF S A M P L E 1. PR O D U C . T CC-)- - S a .-* ' / ' C e 4. D A T E R E C D 5. R E C E I V E D F R O M ' . . . _ 2. S A M P L E N U M B E R ^ >'V? 6. D I S T R I C T OR D IV IS IO N 8. NET CON TENTS N O T a p p l ic a b l e not d et e r m in e d U N I T S EXAMINED SUMMARY OF ANALYSIS I 1D E C L A R E D ________ AMOUNT FOUND, % O F D E C L A R E D _____ c? 'C CV >} \ f. V v C 1 ; u ~* tV r/ /o ?/ '( ) s >Y (/? * \ . O . */ r ' / c -- / * /, / * , V- v... / i f '"" cl - 3 -A / v ^ V --Cc A t; /.. / .' L// . 7;\ ,, / , ' <' " *' ; r / J9. I I O RI GIN A U S ) S U B M I T T E D L A B E L - ` ING ____ COPIES SUBMITTED I I NONE i/ / . / 6 ~ ,7 v . // > ' f ". <*' i,,. t a 11. R E S E R V E S A M P L E 12. D A T E REPORTED 13. AN A L Y S T (e) N A M E ' /;: & "'>- ! u // , / 13b. N U M B E R 13c. P C j l 4. CALCULA TIONS CHECKED b. DATE 15. P R O G R A M D A T A JELLS, P 8 QBF.EM OP ER ATIO N H IA /D C C NO. ACTIVITY NO. OF ,O TS HOURS L 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 n o more than two) (A) M ACROSCOPIC (M) M I C R O S C O P I C (X) X R A Y (F) | | FIE L D EXAM (P) P H Y EXAM (B) | |BA C T (O) O R G A N (C) CHEM (N) w / O ANAL (L ) BIO GPO 934-26 L - " 1. P R O D U C T ANALYST WORK SHEET err'. "C o 3. S E A L S INTACT 4. D A T E R E C D 5. R E C E I V E D F R O M BROKEN I 1N ONE 7. D E S C R I P T I O N O F S A M P L E .`" 'V 2, S A M P L E N U M B E R 6. D I S T R I C T OR D IV IS IO N 8. NET CONTENTS | [NOT APPLICABLE N O T DETERMINED U N I T S EXAMINED 10. S U M M A R Y O F A N A L Y S I S U' 1 |DECLARED AMOUNT FOUND % OF DECLARED % 'y ' ) r~ i LABEL- ING | | ORIGINALtS) SUBMITTED | | ____________ _________ C O P I E S S U B M I T T E D | j NONE o rv (n rr /- / c . A c f-C Ta r ~/'0 u ./- Z / / 7 / / -rr a /-d 11. R E S E R V E S A M P L E 12. D A T E REPORTED o r- 13a. A N A L Y S T ('sJ N A M E rih 13b. N U M B E R 13c. P C 14. CALCULA TIONS CHECKED b. D A T E 15. P R O G R A M D A T A MS, PROBLEM OP E RA T I ON H IA/ DCC N ) A C T I VI T Y NO. OF LOTS HOURS 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 more then two) ( 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) l | FI E L D E X A M (P) P H Y E X A M C B ; Q b A C T (O) I O RGAN (C) C H E M (N) Q W / O A N A L ( L ) B I O GPO 934-26J ANALYST WORK SHEET 3. S E A L S I I INTACT [^BRO KEN I I NONE 7. D E S C R I P T I O N O F S A M P L E 1. P R O D U C T 4. D A T E R E C O .- ) 5. R E C E I V E D F R O M 2. S A M P L E N U M B E R n 6. D IS T R IC T OR D IV IS IO N 8. NET CON TENTS | | NOT A P P L I C A B L E | | NOT D E T E R M I N E D U N I T S EXAMINED 10. S U M M A R Y O F A N A L Y S I S 1 |DECLARED AMOUNT FOUND % OF D EC L A R ED , ! ) O Rl GIN A U S ) S U B M I T T E D LABEL- j l ING | _________________________ C O P I E S SU BM1 TT ED | | NONE C' / C-v/ C /- 11. R E S E R V E S A M P L E 12. D A T E REPORTED f t ! f 't 13. A N A L Y S T S N AM E // y 13b. N U M B E R 13c. PCi14. CALCULA TIONS C H EC K ED b. D A TE 15. P R O G R A M D A T A MS, fijt R S E JiFM OP E R A TION H A / D C C NO AC TI VI TY NO. OF LOTS HOURS 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 m ore th a n tw o) (A) M A C R O S C O P IC (M) M I C R O S C O P I C (X) p X j R A Y (F) F I E L D E X A M (P) PH Y EXAM (B) ( B A C T fO ) I jORGAN (C) C H E M (N) Q W / O A N A L ( L ) BIO GPO 934-26 - ANALYST WORK SHEET 3. S E A L S |~1 IN TAC T QTf B R O KE N 1 ~| NONE 7. D E S C R I P T I O N O F S A M P L E 1. P R O D U cTt 4. D A T E R E C O 5. R E C E I V E D F R O M 2, S A M P L E N U M B E R 6. D IS T R IC T OR DIVISION } 8. NET CON- TENTS | | NOT A P P L I C A B L E | | NOT D E T E R M I N E D UNITS EXAMINED 10. S U M M A R Y O F A N A L Y S I S 1 1DECLARED AMOUNT FOUND % OF DECLARED 9. LABEL- ING ORIGINAUS) SUBMITTED | | __________________________C O P I E S S U B M I T T E D ] 1N O NE '/ ),,- /-- K/ K 11. R E S E R V E S A M P L E 12. D A T E REPORTED h in 13a. A N A L Y S T (e ) N A M E 13b. N U M B E R 13c. P C 14. CALCULA TIONS CHECKED b. DATE 15. P R O G R A M D A T A EMS, NP aR Q BLE M OP E RA TION a /dcc no. AC TI VI TY NO. OF 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 . METHOD (C h e c k no more th en two) (A) Q ] MACROSCOPIC (M) [ 1 Ml CROSCOPI C (X ) X j RAY (F ) 1 | FI E L D EXAM (P) PHY EXAM C B j Q B A C T (O ) \ |ORGAN (C ) CHEM (N ) Q^]W/0 ANAL (L.) [ ^ ] BIO GPO 9 34-261 ANALYST WORK SHEET 3. S E A L S 1 1I N T A C T BROK EN I 1N O N E 7. D E S C R I P T I O N O F S A M P L E 1. P R O D U C T 4. D A T E R E C D <T 7 ; . v u / t . / / js> / c 5. R E C E I V E D F R O M A li ro . 2, S A M P L E N U M B E R 6. D I S T R I C T OR DIV ISIO N f NET CON TENTS NOT APPL! CABLE | | NOT DETERMINED I | UNITS EXAMINED 10. S U M M A R Y O F A N A L Y S I S D E C L A R E D ______ _ AMOUNT FOUND, % O F D E C L A R E D ____ /' i ? t /? ' /U - . / tv c 9 ! I I O R I G I N A L I S ) S U B M I T T E D L A B E L - j ING ____ C O P I E S S U BMI T T E D I I NONE 7 "7 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 L Y S T f s ) N A M E 13b. NUMBER |13c. P C 14. CALCULA TIONS CHECKED b. DATE 15. P R O G R A M D A T A P.8.PBLE M OP ERATION H I A / D C C NO A C TI VI T Y NOOF. 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 c k no more then two) (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 ) J X i R A Y (F) F I E L D E X A M (P ) P H Y E X A M ( B J O b A C T ( O ) I |p RG A N (C ) C H E M (TV) Q W / O A N A L (L ) B I O GPO 934-26! r " ~ -- ! ANALYST WORK SHEET 3. S E A L S 1 1I N T A C T ITT B R O K E N 1 1N O N E 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 Asm 4. D A T E R E C D *; /e 5. R E C E I V E D F R O M jC 2 ,f ; , i ra 2. S A M P L E N U M B E R 6. D I S T R I C T O R D I V I S I O N . 8. NET CON- TENTS not APPLICABLE NOT D E T E R M I N E D UNITS EXAMINED 10. S U M M A R Y O F A N A L Y S I S | 1 DECLARED AMOUNT FOUND % OF DEC LA RED 9m LABEL ING 1 1ORI GINA L(S) SU BMI T T E D . COPIES SUBMITTED 1 1N O NE , '/ ( 9 c --i / C' - V : l w V I W J ; / / 6 S : '6 - / / ^ /f r-: S / / / / Ls L.- ' '/ ., - ^ V ' v - --. "~J / /. / / ' tl- ; / / / ` / * ' V ALa ( 'S' / /- 1 1. R E S E R V E S A M P L E 12. D A T E REPORTED 7 13e. A N ALYSTC s_) N AM E 13b. N U M B E R 13c, PCJ14. CALCULA / TIONS CHECKED b. DATE 15. P R O G R A M D A T A f q P P.1,EM FD FORM 431 (8/72) OP E R A TION H I A / O C C NO A C T I VI T Y NO. HOURS J METHOD ( C h eck no more than two) J (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) I I FI E L D E X A M (P) PH Y EXAM C B ; Q b AC T (O ) I ORGAN (C ) C H E M (N) w / O A N A L (L ) I I BIO P R E V I O U S E D I T I O N IS O B S O L E T E . GPO 934-261