Laserfiche WebLink
CH dN OF CUSTODY <br /> 'SAMPLE (`signat ure): <br /> %%.T �"ti-- App/ied GeoSyst�ms <br /> 4191-E Power Inn Road,Sacramento,C-k 95926 (916)452-2901 <br /> Phtsne: r r��� ��Z7}! .Fremont •Costa Mesa <br /> Sacramento <br /> LABORATORY: SHIPPING INFORMATION: <br /> 4 Shipper <br /> Address <br /> Date Shipped <br /> TURNAROUND TIME: Z txc. Service Used <br /> Attention: Alrbill No, Cooler No. <br /> Phone N.6 — Tib ^fir,. "Z Yo/ <br /> Relingt#shed by:(sl stunts Rec 'ved by:{signat esi E]aie Time <br /> Received for aboratory by. <br /> . '-ABORATORY—gKULd SIGN UPON RECEIPT AND RETURN A COPY OF THIS FORM WITH THE <br /> -- LABORATORY RESULTS <br /> Sample Site Date Analyses Sample Condition <br /> No. Identification Sampled Requested Upon Receipt. <br /> CU-53 /Awl- t5,0 E.i IGci r+m rG . f{Ei.f�, <br /> SA2— , � — <br /> f, <br /> v <br />