Laserfiche WebLink
CHAIN OF CUSTODY RECORD <br />Client nam L t <br />Project or PON <br />Address <br />Phone N <br />City, State, Zip <br />Re anent' r` <br />Lab <br />Sample <br />number <br />Date <br />sampled <br />Time <br />sampled <br />T' e' <br />1� <br />See key <br />below <br />Sampledby.r' <br />L' <br />Number <br />of <br />containers <br />Sample description <br />2 <br />y� <br />•' <br />-rt- <br />Name <br />B t Log Number <br />Anal�e§ rei>'aired 1 ; .I• r„`i fi ®t <br />V. ell <br />5 f R <br />Remarks, <br />We— <br />Company Date rTime <br />Relinquished b / y/ 1 c, 5•v <br />t M18Lp�L <br />Received • L/ 0©tlruc. ' • l�A , J <br />Relinquished by <br />Received by <br />Relinquished by <br />Received by Laboratory , <br />B C ANALYTICAL Note.: Samples are discarded 30 days after results are reported unless other arrangements are made. 'KEY' AO—Aqueous NA—Nonaqueous SL—Sludge <br />13 1255 Powell Street, Emeryville, CA 94608 (415) 428-2300 Hazardous samples will be returned to client or disposed of at client's expense. GW—Groundwater SO—Soil OT—Other PE—Petroleum <br />❑ 801 Western Avenue, Glendale, CA 91201 (818) 247.5737 Disposal arrangements: <br />13 1200 Pacifico Avenue, Anaheim, CA 92805 (714) 978.0113 <br />