Laserfiche WebLink
Columbia <br /> Analytical <br /> Courier Sampie Receipt Record SeiviceSinc <br /> Date � f <br /> omDariv <br /> Protect Nvo L <br /> `'umber or Containers — <br /> Coolers _ Boxes _ Other <br /> Custodv Seal(s) Present YES NO Custodv Seai(s) Added YES NO <br /> Containers Relinquished By Signea Name <br /> Printed Name <br /> Companv Cow . <br />. Date and Time /0 <br /> Containers Received By (Couper)- Signed Name <br /> Pnnted Name 0 'l,,,Uw/ ?� ' <br /> Companv 4 <br /> Date and Time /-�C-- C, <br /> Containers Relinquished By (Courier):Signers Name <br /> Printed Name <br /> Companv <br /> Date and Time 4)L%r4 s= <br /> r <br /> Containers Received By (Lab): Signed Name <br /> Pnnted Name Z-aJ-Q'4' L VI b <br /> Date and Time <br />. `'ate Samples received via courser will be otficially received and processed at C.-\S' Sample Receivmg Office <br /> 1921 Ringwood Avenue. San Jose. California 95131 <br /> Telenhnne- -ing--vv%7-inn r., IR_d'i7-qz,4 <br /> C0tmn:n7 n0C -U7 95 <br /> C <br />