Laserfiche WebLink
California Water Labs, Inc. <br /> P.O.BOX 4249 •1 <br /> 1430 CARPENTER LANE—SUITE G <br /> MODESTO,CA 95352 s <br /> PHONE(209)527-4050 <br /> CHAIN OF CUSTODY RECORD <br /> PROJECT NAME: �• <br /> D <br /> De GYcot S ? OyI <br /> SAMPLERS (signature) Number �Qa� REMARKS <br /> II <br /> of <br /> i Station Con- <br /> Number Station Location <br /> Number Date Time � tamers <br /> 5p� 6;4 6 <br /> y-, z <br /> Pi>c �u3r�e I E' - <br /> 1 1 � <br /> 'j <br /> yon <br /> i <br /> 1. • <br /> 1 � <br /> Relinquished by(signaturej: Date / Time Received by (signature): <br /> Rel ed by(s tur D /I,Ti�me1 Received by (signature): (n <br /> ��� 7 IU w Company or Age�ry: <br /> °01mp Company or Agency: Company or Agency: .� - <br /> C7o an or cy: ) A O <br /> Date / Time Received by (r1patu+i4): <br /> Reliinquishe by{�igna� ): Date / Time Received by (signaturf): <br /> Relinquished by: <br /> ';.f 414• Company or Agency: Company or A <br /> Company or Agency ',` • p y <br /> Company or -A - <br /> R I � <br /> ( b Date / Time Remarks/Shipping Information N b <br /> Relinquished by(signa ure): Date / Time Received for Laboratory Y: <br /> (s nature) <br /> Company or Agency:'/��' 6.��- <br /> i t <br />