Laserfiche WebLink
N <br /> sl <br /> I <br /> i <br /> INTE&NATIONAL:. .• RIA Control No. NO 17 g d <br /> CT RPOORATION CI; MN-OF-CUSTODY RECORD 265239 <br /> C/C Control No. <br /> PROJECT NAME/NU JMBER LAS DESTINATION _-- 11- rZCCI 40" A1 lAt-'r°1 it 1.11 <br /> SAMPLE TEAM MEMBERS ~� q&)f oW ..r-c-Atj CARRIER/WAYBILL NO. caur_ i 1z rz <br /> Sample Sample Date and Tirna Sample Container Condition on Racaipl Disposal <br /> Number location and Description Collected ' Type Type (Name and Datal Record No. y{' <br /> SOIL _ ''X (c` '7Utacl <br /> r . <br /> .Qr 7F;I.11l' <br /> cry:=-rr.irr�z ' .� / ?(.•�t' 7'1'-�!! •C%/�Vc, � 4' <br /> 7'frwra.r Vtit-1 /G.OI 7. f► !_'(d ' <br /> t , Lei. <br /> W41 7 <br /> sr <,rntvz ! I vid Z 11-911 7•3750 lgil(v <br /> i�T o'lru1.z: I Vlt) Z 7/•L' 7• l rl e r =A�!L - x err -I It'k <br /> 3: <br /> Special Instructions: ! <br /> r <br /> { <br /> Possible Sample Hazards: � I t 1 <br /> SIGNATURES: (Name,Compa y,Date and Time) �r <br /> 1. Relinquished By: '-� 7��.°.« 7 3. Relinquished By: <br /> .�.. <br /> r. <br /> Received By: �cti J s* w a.. i /- / Y.� 1^.Received by, <br /> 2. Relinquished By: K 4. Relinquished By: <br /> is �> <br /> Received By: Received By: <br /> WHITE-TaOccompanyampre'a <br /> Ow-ci..7A r.R.v .. - 127A-10-05 <br /> - n h <br /> A . <br />