Document Rj79odrpgE2nQgxwGeRz4zVRB

ANALYST WORK S H EET i 3. S E A L S |_ ) INTACT broken 1 1NONE 1?. D E S C R IP T IO N OF SA M P L E 1. P R O D U C T ____ 7T> f f 4. D A T E ' R E C D /Al is. t or.e__c_e_i_v__e/d-O .Ff r,o^mvV C- / # s-* _ J ( ____ L i r J A t - ^ ; y--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 /X / / r c / . v t / t f ,r - ...... - 7 ,A L , ^ 1 A ^ F * / / m C t , s c e r t e / * * . * > * 7 _______ ; \ et 1 CONTENTS --------- ^ ------------------.--*-k--P--\------y----------.-.-/-%-- --,-T---.---------.-<-- 1 1N O T A P P L I C A B L E r l DECLARED { | NOT DETERMINED AMOUNT POUND / * 4 _-.--------j S t 7 . / 'r / L 9.a b e l ORIGINAL(S) 11 SUBMITTED C O P IE S SUBMI T T E D - -- Q u n its EXAMINED % OP D E C L A R E D . ing j 1NONE 10. SUMMARY O F A N A L Y S IS O ? / ^ / // < ?. / / /"* / S > ( f 3- T /c V &f'Acft&/+tf s~ / t i (fi. //.(/,/* AAr 77 7, L/ */* / t / *~c />/w ^ :/ 7 ? ^ jL ? , /~ / S P titd tL 11. R E S E R V E S A M P L E 12. D A T E REPORTED 'P * / >/ ''/(& j / / 13e . A N A L Y S J f e ; NAME / u /. C/ 15. P R O GR A M D A T A M S NO. PROE L E M OP ERA TION 13b. N U M B E R 13c. P C 14. CALCULA TIONS CHECKED A C T IV IT Y NoOr. LOTS HOURS M E T H O D (C heck no wore than two) (A) Q M A C R O S C O P I C (M) [ ^ M I C R O S C O P I C (X ) (F ) X i R A Y | | FI E L D E X A M (P) Q p h y e x a m (O )C B ) Q b a c t [ |o r g a n (C) C H E M (N) w / o A N A L (L) BIO F D F O R M 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 . G P O 934-261  ANALYST WORK SHEET : 3. S E A L S bro ken in t a c t 1 1NONE 7. D ESCRIPTIO N OF SAM PLE .............. " " 7 4. D A T E R EC D 5. R E C E IV E D FROM , / . S , - i n / 9 --e. xt 6. D IS T R IC T OR D IV IS K !. ,............/ l r / / / P P i if. { f t 'fjP. i ( f ' / f . i A c m i ? "f* ^ y -/f * ... Jjeu L f r f r * ______ / J r l ~r~ |e. , NET ; CON* ! TENTS nN O T A P P L I C A B L E | | NOT DETERMINED ) UNITS EXAMINED 1 1DECLARED AMOUNT FOUND, , , % OF DECLARED tO. SU M M A RY O F A N A L Y S IS / }} 7> / c --- - -- / / fj el . s. La bel in g / I / 1. r r s r f 7/ r /f,. ,/ h"/ / r r /V'C v U I T _____/ / L ,, ORIGINAL(S)SUBMITTED 1 1 COPIESSUBMIT1 1 1NONE L / /' / f f C / / Jf C Q O <?**-% / / / T / c- p 9 S "Z J (r y$ > I && rj /- pe ~ p / c < /% / / f / W c ? V / - C . V re * c -c 'C /t t yS r9? // f t / 9 -e*. / / ee. C & -* S e *t / 1!. R E S E R V E S A M P L E 12. D A T E REPORTED 2 Y flu * 15, P R O G R A M M A TA 13. A N A L Y S T ^ ; N A M E . -P . ;/(/ c/ O P E R A TION JAS. F R O f t ^ M A / D C C NO /%M ax /^ p /P L , ^ 3b. NUM8 ER 13c. P C 1. CALCULA TIONS C H E C K E D b. D A T E ACTIVITY NO. OF OTS M ETHOD (Check no more (A) m a c r o s c o p ic than (m ) two) |M ic r o s (X ) (F)Q X . . R A Y | | FI E L D E X A M (P) PHY EXAM (B )C D B A C T (0)\Z (C) C H E M (N) W / O A N A L (L) c p n Q' G P O 9: ci D n o*  / r . ; V/ ` / L a -V-`/y j- i s s - jN i J f/ - / s > r* V y J !, \d /7 r 7 > . ' /7 3 qd / V' V' /// - ;) // ^ * > ?- '/ / C/ 7/ * / r j y 7 /y ?- * ; ''i y> y r~> c / ) ' *-s 7 > ) ' '/ /Y - A .' } f, / 7 f - u -*>w \ -i y - i * . ' \ 4-/, s ' . v` > ~- ' 'S .'' J S 7 / - > / ") ' *// i r i / *//^.c / **>'Z. ,-*' '' > "7-~'fS ; >" - v \, ;7 > y / ? '; y "'7 : ' ' > .> /'; - v '* . / -s :' ~ iA . r > " a? w o ry "Z > 7 - 7 ' ' V/ /^ -r n J ' S S ' 'j 1 J r > 7- W. *%g) ,v -/ 7 /r 7; 7 "7 i / : ; ?j J s/ ,c- ?l /u/ / * h -y i AN ALYST WORK SHEET 3. S E A L S INTACT BROKEN I 1NONE 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 T i ''e . ./ 4. D A T E R E C D 5. R E C E IV E D FROM /c ! ` 2. S A M P L E NUMBER 6. D IS T R IC T OR DIVISION s* <' 8. NET CON TENTS Q NOT a p p l i c a b l e NOT DETERMINED UNITS EXAMINED 10. S U M M A RY O F A N A L Y S I S DEC LA RED/UNIT, AMOUNT FOUND % OF DECLARED . 9. LABEL I NG I I ORIGINAL(S) SUBMITTED ( | __________________________ C O P I E S S U B M I T T E D | | NONE 2* . . A / < f f t <' 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 fe ; NAME 15. P R O G R A M D A T A PM?, HP, 1. PROBLEM O P E R A T I ON H lA /D C C NO A C TI VI T Y NOOF. -OTS FD F O R M 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. N U MB E R 13c. PC 14. METHOD/ CACULA- TION b. DATE CHECK M ETH O D (C heck no more than two) (A) M A C R O S C O P I C (M) n ~ | M I C R O S C O P I C (X) X . - R A Y (F) I I F I E L D EX AM (P) P H Y E X A M (O )f f l j Q B A C T i |pRGAN (C ) C H E M (TV) w / O A N A L ( L ) B I O PAGE PAGES. ; A N A L Y ST WORK SH E E T ;3. S E A L S ('Ti n t a c t { | BROKEN [) NONE 7. D ESCRIPTIO N OF SA M PLE 1. P R O D U C T Te 4. D A T E R E C O fc. 5. R E C E I V E D FRO M v / V {if f, o V? / / - ' ' /* / V SAM PLE NUMBER 6. D IS T R IC T OR DIVI . f -r- 8. NET CON TENTS n o t APPLICABLE NOT DETERM INED UNITS EXAMINED 10. SUMM A R Y O F A N A L Y S I S D ECLA RED/UN1T AMOUNT FOUND % OF DECLARED . 'C 9. LA B EL ING 0 ORIGINALlS) SUBM ITTED || C O P IE S SUBMI' | | NONE o, 1 1. 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 f ; N A M E 15. P R O G R A M D A T A P M S NO. PROBLEM OPERATION H 1 A / D C C NO 3. 13b. NUMBER 13c. PC. 1 4 . a. BY M ETHO D / CACULA- TION b. DATE i CHECK ACTIVITY NO. OF LOTS HOURS m e t h o d (Check no more then two) (A) Q M A C R O S C O P I C (M) R~| Ml C RO (X) m X rR A Y (F) | | FI E L D EXAM (P) Q PHY E X A M (B) I | B A C T (O) [ (C) CH EM (N) 0 / 0 A N A L (L } ANALYST WORK SHEET 3. S E A LS ( B roken LJ INTACT 1 | none 7. D ESC R IP TIO N O F SA M P LE T '^ / c 4. D A T E R E C D 5. R E C E IV E D FROM . A .s _ j, 6. D IS T R IC T OR DIVI 7 o / c , . J . ' / & / '/ a n *4-h . .. ,/ 7 i * J S 7 2 a A* / VZ 72a h tff 7 / ? j J 'j f 3 C .. ^ ______ 2 ' 8. NET CON TENTS | | NOT A P P LIC A B LE | N O T DETERMINED UNITS EXAMINED D E C L A R E D / U N 1T AMOUNT FOUND % OF DECLARED 9. LA B EL ING 1 1 O R I GI N A L ( S ) SU BMI T T E D C O P I E S SU BMI ' 1 1NONE 10. S U M M A R Y O F A N A L Y S I S // j) O' , V " ', . '/ C > t. r;'-/ y* ; y f ' * i -5*.7-/f - /" /7 (' !/ ; 4c **> / cy /y . 'c / r A C 1 s7; r / y ` l < - ' * *7 C .v *7 7 . -- / 11. R E S E R V E S A M P L E 12. D A T E REPO RTED ; ! `' * ' 'S * . -V ' v1 13a. A N A L Y S T ^ ; NAME fi . 5. P R O G R A M D A T A MS. NO, PROBLEM OPERATION a / p c c no 3. 13b. N U M B E R 1 3 c. P C 14. a. BY ' ."7" 1 METHOD/ CACULA- TION b. DATE CHECK A C TI VI T Y NO. OF OTS M E T H O D (Check no more than two) (A) M A C R O S C O P I C (M) r ^ T C R O (X) (F) X . - R A Y F IE L D EXAM (P) Q P H Y E X A M (B) B A C T (O) [ (C) C H E M (N) Q W / O A N A L (L 11. R E S E R V E S A M P L E 12. D A T E REPO RTED fu /y 7 13a. ANAL^YSTfe) NAME f ,, / 13b. N U M B E R 1 3 c . P C 14. M ETHO D/ CACULA- TION b. DATE I CHECK 15. P R O G R A M D A T A M 5. N.O-i PROB LE M OP ER A TION H l A / D C C NO. 3. ACTIVI TY NO. LOTS HOURS M E T H O D (Check no more than two) ^ ) Q MACROSCOPIC (M) n ^ M l C R O : (X ) (F)( T ] X - R A Y | | FIELD EXAM ( P )) P H Y E X A M (B ) B A C T (O ) [ (C ) (L C H E M (TV) w / O A N A L