Document QNMwzgEM3X4op0mZVaarnwdo

ANALYST WORK SH EET 3. S E A L S INTACT FT! BROKEN d ) 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 4. D A T E R E C D /- > / n j 5. R E C E I V E D F R O M -L_____ ti ' o - 7 c? A 2. S A M P L E N U M B E R 6. D IS T R IC T OR D IV IS IO N '> 8. NET CON TENTS I I NOT A P P L I C A B L E ( not d e t e r m in e d UNI TS EX AMI N ED 10. S U M M A R Y O F A N A L Y S IS D E C L A R E D/U N I T . AMOUNT FOUND % O F DECLA RED . / 9. LABEL ING ( O Rl GIN A U S ) S U B M I T T E D | | __________________________ C O P I E S S U B M I T T E D I I NONE - iS ~ " < / ` / o /e u /j^ f rd // ' r ,r . /h c x 'jC /r H , i f ' (7 -'U S -C y /, / / Zc C. " /" 7 y L {'0 / / 11. R E S E R V E S A M P L E 12. D A T E REPO RTED 13a. A N A L Y S T / ; N AM E *\ / 15. P R O G R A M D A T A P M S NO. PRO BLEM OP ERA TION HlA/DCC NO 13b. N U M B E R 13c. P C 14. METHOD/ CACULA- T ION ; CHECK b. D A T E A C T I VI TY NO. ,OTS HOURS METHOD (C h e c k no more than 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) | j FI E L D EXA M (P) P H Y E X A M ( ' B j Q B A C T (O) I |p R G AN (C) CHEM (N) Q w / O A N A L (L) BIO 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. o, UtS I MIO I UK Ul VISION C l B R O K E N _______________C A N O N E 7, D E S C R I P T I O N O F S A M P L E I 'P A / / a . . )x / / / 8. NET CON TENTS [ I N C' f A P P L I C A B L E [" N O T Ol T E RMIM E O f~ ' u n i t s k x a m i n rt> 10. S U M M A R Y O F A N A L Y S I S I P E L L A P E P __ A M O P N T I <L o I" r<I" c l a k r p ,o, W I H I U U K DIVIS ION !i LA BEL IN G I[ ] O R I G I N A L(5| S U B M I T T E D COPIES SUBMITTED / ' / ' c /' / ; C <s / v . / PC / i - C > ,-x / s tJ / <-* X y f ` ' j . / ,/ P o -3 / fF ' WA .e '' ' * ^ / tH (/ " ' " . * v> /U , / // ., 1{ / .. / L- < '> ' ' * t f /V / W o / ' f ; : ../ j -> / , ' .f ' ^ 'V ( /. , . , / / , / r / /' ' ` / ' f/ / / C W f '1 ' '' < ,/ C .- L - ' .- V / 1 /"* PLE11. R E S E R V E S A M P L E /X / 12. D A T E REPO RTED y ^ *' f. s s 13a. A N A L Y S T (s ) N A M E 13b. N U M B E R 13c. P C 14. CALCULA- TIO N S CHECKED a . BY b. DATE 15. P R O G R A M D A T A .ELlSr-mL PROBLEM OPERATION H IA / D C C NO. A C Tl V] TY Nu. ,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 heck no m ore then tw o) (A ) MACROSCOPIC (M) | 1 M I C R O S C O P I C (X ) QTj Xj RAY (F ) | | F I E L D EXAM (P) Q ] PHY EXAM (B) Q B A C T (O) I ORGAN (C ) O CHEM (N) Q W / O ANAL (L ) B ' G P O 934-261 - / ' / V a.. , I T i f i i r i t i n f ' ....... v- " ` " '7"' -7 f * * ."jrjit-- -- -, ' * . . . : -.y V -V' ' ` . . V a : v-" . i \ j ;-v .. p *r" ^ w * * r u u>pnj qui rr. ANALYST WORK SHEET 3. S E A L S H T b ROKEN i i in t a c t r~l N 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 77? / t 4, D A T E RECD J 5. R E C E I V E D FR O M 7 < ' ' . 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 u. a~*~ 6. N ET CON TEN TS not a p p l ic a b l e N O T d et er m in e d [~~1 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 ' / ! I DECLARED AMOUNT FOUND, % O F D E C L A R E D , ____ / t> / '/ t / J/ r- / / J " J >c. - ,,/ / Z';,' Sc j La b e l-I 1NG j I I ORIGINALO) SUBMITTED j COPIES SUBMITTED I NONE <7 ( '. ' / i /- , V 'C < 7 , f . . L/ , ; V ' J l r -5 I, c / 11. R E S E R V E S A M P L E 12. D A T E REPO RTED 13. A N A L Y S T f s ; N A M E . '/ 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 EMS MB. PROBLEM OP E R A T I O N H I 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 . METHOD (C heck no more then 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) FIE L D EXAM (P ) PHY EXAM C B ; Q b a CT (O) I |o R GAN (C) CHEM (N) Q w / O ANAL (L ) I I BIO G P O 934-261 ANALYST WORK SHEET 3. S E A L S I BROKEN INTACT ) NONE 7. D ESC R IPT IO N OF S A M P LE 1. P R O D U C T --/.x<? . 4. D A T E R E C D y / fj-.-i v / * - 5. R E C E I V E D F R O M / y /;? ? y y -- .7 A './ , ,, f . - / ' y O ' - /,* / ? / 6 , ~` c. 2. S A M P L E N U M B E R 6. D IS T R IC T OR D IV IS IO N 1 6. NET CON TEN TS Q not applicable not d e t e r m in e d ) UNITS EXAMINED a. 10. S U M M A R Y O F A N A L Y S IS [ | D E C L A R E D , . _____ AMOUNT FOUND, % O F D E C L A R E D . . ___ s. La b el in g I 1 ORIGINAL(S) SUBMITTED | | __________________________ C O P I E S S U B M I T T E D | 1 NONE i. 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 MS 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 1 14. CALCULA / TIO NS C H E C K E D b. D A T E OP ER A TIO N H 1A/DCC NO. ACTIVITY NO. CO F 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 . METHOD (C heck no more then two) (A) Q MACROSCOPIC (M) MI C R O S C O P I C (X ) X . - R A Y (F) | | FI E L D EXAM (P) Q ] PHY EXAM fBJ B A C T ( O) [ ORGAN (C) ( CHEM (TV) W / O A N A L ( L ) ( BIO G P O 934-261 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. ANALYST WORK SH EET 3. S E A L S I I IN TAC T I I BROKEN P H NON 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 & . C- 7 f--c, o r 1 5. R E C E I V E D FR O M ?v * }/ X JL / 777 V. U e y /i-t s ', r?~ M 2. S A M P L E N U M B E R 6. D IS T R IC T OR D IV IS IO N / oe /c 8. NET CON TENTS I I NOT A P P L I C A B L E NOT D ET ERM INED UNI TS E X AMI N ED 10. S U M M A R Y O F A N A L Y S IS D EC LA RED/UN1T. AMOUNT FOUND % OF DECLARED 9. LABEL ING | | ORIGINAL(S) SU BM ITTED | | __________________________ C O P I E S S U B M I T T E D | | NONE I Ta /c ^ X. 3> C S, Car C or c\-/< 7 A y c y. <^ / ) 4~ lCy (/ 7*?=-- ---- //a A t ri x / -Cf-i ( a /*/* -- 77'-ac-c. C4J$ny-<. /L ~ ^ ^rl/y 7 . 7y c/ o c/ ` /c * / / / r- t // t r A/-^ 7- o_ ' / % y /1 / y te / r A / f ' y / .< / v ' /. 7 7-1 , C 5> S^ jT I / & / &- -/ ' t t v /A r C c y r s o - </ o 11. R E S E R V E S A M P L E 12. D A T E REPO RTED .j f y y r' 13a. A N A L Y S T f s ; N AM E S iP -7 -/-if\ 3/ 3 ' 15. P R O G R A M D A T A OP E RA TION ELLS, PROBLEM H IA / P C C NO. 7 ---- J 3b. N U M B E R yU 13c. P C 14. METHOD/ CACULA- T ION I CHECK b. D A T E A C T I V I TY NO. OTS HOURS METHOD (C heck no more then 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.-RAY f F J F I E L D EXAM (P) PHY EXAM ( S J O b ACT ( O ) | [ORGAN (C) CHEM (N) w / O ANAL ( L ) BIO 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 . PAG E O F PAGES.