Laserfiche WebLink
M M M <br /> ASSOCIATED LABORATORIES <br /> eos N Batavia•Orange, CA 92868 �706? CHAT OF CUSTODOrECORD <br /> (714) 771_,,0 <br /> 714) 771-13900• FAX (714) 538-1209 <br /> Date 6 Page._., of� <br /> CLIENT k ///j <br /> ADDRESS t� � ROJECT MANAGER <br /> t r op–P i�l C) Samples Intact Yes No <br /> �� i✓/¢ ,V Zl PHONE NUMBER County Seals Intact Yes No <br /> � 5 �3 S�'j Sample Ambient_ Cooled— Frozen_ <br /> PROJECT NAME SAMPLERS (Z�77 <br /> 1 Same Day 24 Hr <br /> Regular 48 Hr <br /> SAMPLELOCATION DATE 41 TIME SAMPLE TYPE NO OF SuSP <br /> TESTS <br /> NUMBER DESCRIPTION WATER AIR SOLID CNTNRS CONTAM REQUIRED <br /> Re h shed by ( ig lure) Received by (Signature) Da /Time I hereby authorize the performance of the above <br /> UP-5I ! � / / indicated work. <br /> Re quashed by (Signature) Received by Lab or an sis � ,J IDate/Time <br /> (Signature) 141;0d-� - PA <br /> Special Instructions DISTRIBUTION White with report Yellow to AL, <br /> Pink to Courier <br />