Laserfiche WebLink
C-"�AIN \OF CUSTODY RECORD -`Bill To <br /> �—re,141054 <br /> N Lan <br /> Sherwood P Q 1 ox 937 er Avenue <br /> Hilmar, California 95324 <br /> Labs (209) 667-5258 AttePon <br /> ,9-6 <br /> h <br /> C O R P O R A T I O N FAX (209) 667-2581 �7 f d ,9-c Page I of/ <br /> Job Number PO Project Name <br /> �Q7 3 Fb,( r7rr <br /> Samplersgnature) Site Address <br /> Pv� LD <br /> q;' <br /> \ <br /> SAMPLE LOCATION DATE TIME NUMBER TYPE Q + <br /> � <br /> (IDENTIFICATION) (MTH/DAYNR) (HOUR/MIN) OF (GRAB OR SAMPLE <br /> CONTAINERS COMPOSITE) MATRIX REMARKS <br /> Nib - 9 3 2 <br /> 9 43 53 4,•/ ,� x <br /> I <br /> Relinquished By (Signature) Date/Time Received By (Signature) Daterl-ime <br /> 1 TURNAROUND TIME <br /> Xf J16 3 A/3�5'- <br /> Relinquished�By,(Signature)� DateM a Rec vedBy (Signatur DateMm 0 30 24 HOUR ❑ <br /> vy�4 3 v �d !/. ..���� 5/ n a3 � <br /> 48 HOUR ❑ <br /> Reh fished By (Signature) Rece ved By {Signature} D to ime 5 DAY <br /> ` �. 10 � - -3 lata 4 ' S U i C �l 61 c13 <br /> DISTRIBUTION Original Accompanies Shipment Canary Copy Sherwood Pink Copy Sampler NOTE Samples are discarded 30 days after results are reported unless other arrangements are made <br />