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HOURS
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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 .
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FD FORM 431 (8/72)
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P R E V I O U S E D I T I O N IS O B S O L E T E .
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ANALYST WORK SHEET
3. S E A L S
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ANALYST WORK SHEET
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FD FORM 431 (8/72)
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M E T H O D (C h e c k no m ore than tw o)
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GPO 934-26
ANALYST WORK SHEET
3. S E A L S
INTACT
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13c. P C 14. CALCULA TIONS CHECKED b . D A TE
15. PRO G RAM D A T A
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M E T H O D (C h e c k no more then two)
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GPO 934-26
ANALYST WORK SHEET
3. S E A L S
I I INTACT
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7. DESCRIPTION OF SAM PLE
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2. SAM PLE NUMBER 6. D IS T R IC T OR DIVISION
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FD FORM 431 (8/72)
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C H E C K E D b. D A T E
OP E RA TION H a / dcc no.
A C TI VI T Y NO. OF
LO TS
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 more then two) (A ) QH M A C R O S C O P IC (M) Q M I C R O S C O P IC
(X ) [T]XRAY (F) F IE L D EXAM (P ) Q P H Y EX A M C B J Q b A C T ( O ) ( |P R GAN
(C ) CHEM (N) Q W / O A N A L ( L ) BIO
GPO 934-261
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ANALYST WORK SHEET
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2, S A M P L E N UM BER
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3. S E A L S
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4. D A T E R E C D
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7. D ESCRIPTIO N OF SAM PLE
8.
NET CON TENTS
not a p p lic a b le i 1N OT D E T E R M IN E D u n its e x a m in ed
10. S U M M A R Y O F A N A L Y S I S
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TIONS
CHECKED b. DATE
15. P R O G R A M D A T A
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ROBLEN
OP ER A TION a / dcc no
A C T I VI TY NO.
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FD FORM 431 (8/72)
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M E T H O D (C h e c k no more then two)
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GPO 9 3 4-26 J
ANALYST WORK SHEET
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8. NET CON-
TENTS
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10. SU M M ARY O F A N A L Y S IS
1 ] DECLARED AMOUNT FOUND
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13b. N U M B E R 1 3c . P C 14. C A LC U LA
, / TIONS
CHECKED b. DATE
15. PR O G R A M D A T A J.a P B In E M
OP ERA T!ON H 1A /D CC NO.
A C T IV IT Y NO. OF
LO TS
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 than tw o)
(A ) [ ^ M A C R O S C O P I C
(M ) | | Ml C R O S C O P I C
(X ) ] X i R A Y (F ) | | F I E L D EXAM
(P ) P H Y EXAM
( B j ^ B A C T (O ) I O R G A N
( C ) Q ] C H E M (TV) W / O A N A L ( L ) B I O
GPO 934-26!
' ANALYST WORK SHEET
3. S E A L S
INTAC T
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1 1NONE
7. DESCRIPTION OF SAM PLE
1. P R O D U C T 4. D A T E R E C D
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2. S A M P L E N U M B E R
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| | NOT A P P LIC A B LE | | NOT D ETERM IN ED U N IT S EXAM INED
10. S U M M A R Y O F A N A L Y S I S
1 |D EC LA R ED AMOUNT FOUND
X OF DECLARED
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( O RI GIN A LIS) S U B M IT T E D
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CO PI E S SU BMI T T E D
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b. DATE
15. PROGRAM D A TA
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M E T H O D (C h e c k 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 ) I I FI E L D E X A M
(P ) PHY EXAM
(B ) B A C T (O) I |O R G A N
(C ) C H E M (N ) W / O A N A L ( L ) I I 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