Laserfiche WebLink
Bs Number MRALYMEQU"CHA CAWY D <br /> Client Name �" p/ ���t G Project of PO# Analysis required <br /> Q G N G 11&f f/G U 25 f lab Use Only <br /> Phone N to this <br /> Address Jr� D y /Q Z/ —f facie section <br /> City State zip f T Report,allenllo ! <br /> S1`47Cl�to �- <br /> Sampled by Sample V $o r� ` <br /> Type Number Lab Seals <br /> Dale Time � • " ' of Sample �Q� O tiro° ���7 <br /> sampled sampled Sea I Sample description ontairiers number (see key J� r°yd Remarks <br /> below betaw) <br /> 10,05- <br /> LI <br /> VV <br /> LlI __U T 1_1�_ <br /> • l IMPORTANT NOTICE No samples will be analyzed without an authorized signature In this section <br /> :hese <br /> hereby requesting BSK s Normal Chain-of Custody Procedures for the above samples I understand that I am hereby requesting BSK s Format Chain-of Custody Procedures for the above samples I understand that <br /> these procedures are generally consistent with(hose outlined in the US EPA 5W 846 and that there is no these generally consistent those kPorContract t e Pm <br /> maaoffWokSeton Fand that there Is acharge of$5000 per worderof00abowhihever is <br /> extra charge for this serviced greater By By <br /> AT Authorized Signature <br /> Authorized Signature <br /> Signature Printf Name <br /> / d Company Date Time <br /> Relinquished by / G.�L/ oZ <br /> R ed by � cse4L_ <br /> Rehn ad d1� 9:5> <br /> Rete N � C,f y,J it 1 S /ac r:�3 'r✓ '�� l ��•'�'7 <br /> Relinquished try tL►� ti/�' C'ar hli� �S PL ifs/�r+f�N / �/ <br /> Received by, � ,� ,� i ! y✓ �L-l /"l`�-+[^ /`!� +!^ �/ ' � � J I <br /> / CC-Sludge <br /> KEY Type AO- ubaus L-Sludge SO-Boll PE-Petroleum QT Other /0 <br /> Seats P-Present B-Broken // 1`I ( ��, y <br /> f�J 1 DISTRIBUTION =— NARY LABORATORY PINK ORIGINATOR <br /> tat ural Laboratories /�`[ 1- -r /4"IJ Note <br /> �/�l't�IS Samples are discaldbtl�d d�ays after results are reported unless other arrangements arA �8 <br /> 51 r ornia 93706 t�7 Hazardous samples will be returned to client or disposed of at client expense !!! <br /> �lPlt'phone 485-8 IQ • �F�x (20 [427 �� J '\ I �� `I 1 + 11 I 4 <br /> A 0011 j.O A % % 2 r VV\ C1 - [ J f Qu �1 � 1l I 1 <br />