Laserfiche WebLink
-:4. Analytical of Custody Record Date <br /> Associates, Inc Page of <br /> 4011 Power Inn Rd , Ste G Company Name A Billing Information <br /> u. �1 pfSbm ( un,CU/,r I9 (rf,dcrx Company Name <br /> Sacramento, CA 95826 <br /> Address 4�,/3/ Cci--P+ OlC(- Address <br /> Voice {916{ 451 5034 City, State, Zip A 1 � �; City, State, Zip <br /> FAX 19161 451 6123 r ✓ �r <br /> ABBS (916) 451 9553 Telephone �S Telephone <br /> FAX FAX <br /> Project Name U Report Attn r f <, , n,a� Contact <br /> Project a 7 r 11 F ; 7' <br /> Contact PO <br /> Control <br /> Sample Date Time Sample Tests # of Sampling Remarks (include Number one <br /> Identification Sampled Sampled Location)Position Required Jars Method type & appearance) Lab Use <br /> Only F P <br /> 12.fy Jl oo '> r� <br /> Total Number of Containers Sampler's Signature F P11"Od <br /> P Prosc,vcd <br /> Relinquished bK� , Company Relinquished by Company Relinquished by Company <br /> Received by Company Received by Company Received by Lab Company <br /> Date 1 Time Temp t'C1 Date !Time Temp (*Cl Date 1 Time Temp ('CI <br /> n,SIrIIII11,nVVf1I1(1 r- Irl irk I itlnraTciry Pink nrgiinatnr <br />