Laserfiche WebLink
i <br /> Chain of STI, <br /> Custody Record _/40• J=rn Trent Laboratories, Inc. f <br /> STL 4124 (0901] <br /> Chen! ��}� Profecl Ma er Date Cham of Custody Number <br /> /f�� S 774 I've10-UE-as <br /> Address TeleAhone Num er(Area Code)rFax Numbsr &*4"nyw p <br /> .L� zfb4- d/ +�g'YH/ 7H b Hr--753-of< < IGSAV( Page I of 1 <br /> G+tState Zip Code Site Contact Analysis(Attach list of <br /> Vaose IZ6/f mores ace is needed <br /> Project Name and Location(State) 5"�c k ld„ c A 'VA1'w aV.Cz"n <br /> 1Sc7z ntracVPurchase Order/Quote No rao y =r ,7 <br /> ? Special instructions/ <br /> Matrix Containers& Conditions of Receipt <br /> Preservatives <br /> Sample 10 No and Description ` x <br /> Date Time <br /> (Containers for each sampla may be combined on one Ane) ¢ 7 z N$ A �' A <br /> al W I !�S �i N x r� <br /> /1'Iiw—!Z I1� <br /> m4,P-13 t <br /> IMF— <br /> Possible Hazard Identification Sample Dispdsa+ a <br /> (A fee may be assessed if samples are retained <br /> Non Hazard ❑Flammable El Skin Want Poison 8 ❑ Unknown ❑ Return To Client ElDisposal By Lab El Archive For Months longer than 1 month) <br /> Tum Around Time Required OC Requirements(Spectfyl <br /> R-24 Hours ❑ 48 Hours ❑ 7 Days -1 to pays ❑2 f Days [I Other <br /> I Rehn u+shed By Date Time t Re + e By Dale Trine <br /> 12. 17 <br /> 2 Relm y Date Time 2 cervedBy D fe L Trine LA— <br /> 3 Rehnqurshed 8y Date Time J Received By Dare Tr, e <br /> Comments .�. <br /> otSTR1B WHITS Returned to Client with Report CANARY Stays wiflt the Sample PINK Field copy <br />