Laserfiche WebLink
q10 213536 <br /> . CHAIN-OF-CUSTODY RECORD <br /> ENVIRONMENTAL LABORATORIES Analytical Request <br /> Client , Report To: �1r��e�C/ uJ' Pace Client No. <br /> Address /y �� A �(¢ Bill To: Pace Project Manager <br /> 1'a� 3 <br /> P.O.#1 Billing Reference d y0 P ce Project No. O <br /> Ru"3 C/,+a CAA `R quested Due Date: .4I Z 9 S� <br /> Phone 7�p� �� — Project Name/No. 7J �� <br /> Sampled By(PRINT): cc PRESERVATIVES ANALYSES <br /> Z REQUEST Q, PLaaai n' <br /> a w e 3 oVeAn;a 7b n 1 <br /> Sampler Signature Date Sampled Z cc , A0 <br /> LL w <br /> ITEM SAMPLE DESCRIPTION TIME MATRIX PACE NO. o Z ° Z o REMARKS <br /> Z _ z > <br /> 4Ito''y <br /> 1 W I — !5 • a ' .S'or 8s 6�� X X <br /> � n� .r. --:aer-r •e rt f � .. � '1 ..:.i1. !'; •a � .73 ti1� �71T�'.F��t s�.��4*�'7'�'S. k;,.l Y���'S�A� «t d.).'�I� -�,t���'j!Y 1 ��ir., tt; .."� ;a ' <br /> . 2 ,] F., ]:'n '..; i?piiT,�1'• jar '+;,, tjSti" w.E1 `"31.'iE'> '�� "s1FJ�v.331 .� ::) <br /> 4 <br /> !' :Ilrcq I! <br /> g ' <br /> . 5 <br /> 6 <br /> i' <br /> 7 "114 <br /> tt ..ass.: _ .� itfsE:t ,� �tr .i� .3:alif.'fy c 1►t t: ,_ �s E � r, :' -lap ' <br /> gSHIPMENT MET D <br /> COOLERCEPTED BY)AFFILIATION <br /> , . <br /> IT DATE RET NED <br /> Additional CommentsUR <br /> v " <br /> 3 SEE REVERSE SIDE FOR INSTRUCTIONS <br />