Laserfiche WebLink
Cr k Environmental Laboratories, Inca Chai'n-of-Cuswdy�. <br /> 141 Suburban Road,Store GS,'San Luis Obaspo,CA 9340I c�reel:labs co C craeklahs co phone(805}545-9838 fax(SOS}545-0107 2af Order## � • <br /> • Please Print In Pen � _ Z <br /> 5811t <br /> t NameCzeoenn r� Contact �j Pho a r� Due Date, <br /> ess i '�U �Ct' Cl �r "i $ 24Hr 48Hr Other Normal TAT <br /> COY S to <br /> tT Fa <br /> y Cell <br /> �J` �I Bee er <br /> e/N er- 11 WINCi, i � - PO# Copies To <br /> (If different from above) Address City State Zip <br /> Sampler Name(Print) Comm <br /> ,i • DW Drinking�Water0 4 � AQ=A ueous L=SOU <br /> Datelrime <br /> SamiB©eSCri tion S8R1 !ed A118( $i8 sof <br /> Matrix B0ftim Proservanve/Type eaLes Creak Lab sample# <br /> WAd <br /> � i <br /> L12,16 <br /> �~ i2-1,S 6 Y30 <br /> 125 3 <br /> 132D <br /> 1335 � l-- <br /> �t � 104 2 v <br /> _ RELINQUISHED BY DATEITIME RECEIVED BY <br /> S ) O"nt) (O tion) I (S ) (Print} <br /> ` q (Or aiimflon) <br /> Creek Environmental <br /> r <br /> Foetn��OAMY Ship' Yfi1 ' <br /> Laboratories, <br /> i <br /> -Tome: <br /> Custody Sealed Yl <br />