Laserfiche WebLink
r ENVIRONM AL ASSESSORS, INC. <br /> Custody Transfer Record/Lab Work Request <br /> Relri erator# LAB USE ONLY <br /> #/Type Container Samples Were <br /> Client Volume <br /> Work Order 1 °o�f t Shipped <br /> hiip peed r Hand <br /> Preservative <br /> Date Recd Date Due NOTES <br /> ANALYST=S ,,�p�S� <br /> �/ a 2PD REQUESTED ''i ( 2 Ambient or Chilled <br /> Client ContacUPhone � NOTES <br /> Client ID/Description Matrix Date �p <br /> Lab 10 Collected '(� 3 Received Broken/ <br /> Leaking (Improperly <br /> S- Sealed) <br /> Y N <br /> NOTES <br /> Y ( S 4 Properly Preserved <br /> Y N <br /> a NOTES <br /> r `3� 5 Received Within <br /> 3 S Holding Times <br /> — 4D Y N <br /> U S NOTES <br /> COC Tape Was <br /> I Present on Outer <br /> 610 Package Y N <br /> r 2 Unbroken on Outer <br /> (05 Package Y N <br /> 3 Present on Sample <br /> Y N <br /> Matrix W Water DS Drum Solids X Other Special Instructions 4 Unbroken on Sample <br /> S Soil 0-011 DL-Drum Liquids <br /> NOTES Y N <br /> SF-Sediment A Air F-Fish <br /> SO-Solid WI-Wipe L- EPrTCLP Leachate <br /> Item/Reason Relinquished by__ Received by Date Time Item/Reason Relinquished b Received by Date Time COC Record Was <br /> 1 Present Upon Receipt <br /> Y of Samples Y N <br /> Id m Discrepancies Between <br /> Sample Labels and COC <br /> Record? Y N <br /> NOTES <br />