Laserfiche WebLink
Chain of Custody Record Qm-lt0 1�E• T=P <br /> ry ect Dame y 0�ut�c �iistt• T=P. <br /> ' Coaditions. <br /> 3P B�JIGENC CO ort�olxa: LL `'� ' <br /> Bl'Laboratory Contract Nranber: Mcteoxolag�cat�+eati• <br /> ,Dake;17,` N- i Reputed Due Date VAn4 Speed' Durct�oa: <br /> S+►ns�'!`�:Q 1rr� '� /GX 1Wi kciliiyNa <br /> 37aasaltaar}Coutracbar: L#� <br /> tb <br /> 5 NameP/G FaciliTy Address ddters• � � �,rnsc-r, ff� JIK Addt OS3 t1 Site ID No <br /> �1GC T atlI <br /> Ing. C ? }I}, <br /> form Global ID P-1 a22COmsaltant/CaziUw*rF. ct No <br /> Iab PM !GII►2 PM Cowart. usOlLaat ContracoCr T Te.rlFax;, lar' �+" <br /> Tele/Fax ss• a nanitsot/contiactior <br /> Report Type&QC l wl rnvoiac t,0, Consaltxat/contractor or SPIGEM (CUCIC me) <br /> 131>/rimm Accrnmt No ToleTax PIGEM Wo*ate,=NO <br /> IAb Tomo Ozi:4xNo. at= Froscrvntives Regttostod Ana4v:ts <br /> � SampZc Point�.at Lang and <br /> Rom $amplaDeseripdon Time 'a Labaratorylo. � 9 5 0 Comments <br /> w <br /> A/- f )IC! a � <br /> 2 Viv• 7 7- <br /> 3 v3 <br /> 4 ' W` 1 <br /> t5 •• q ac , <br /> T �3 13 0 ' }C <br /> 1(2, Y, <br /> °s C <br /> 18 Vw-I 1 <br /> t <br /> e's.Name' r sLLativ WlingL&bedBYIAfMat%z DIE Ti= A es Campan :cat Daae: �D k <br /> �IIpmeat Method. ' <br /> eat Trackmg No. <br /> 3oi7astznctioa� <br /> 4 Seals LI Placc Yes No Tc�peratur�B1�nk Yrs No _ Cooler Terapaat=om Rcccipt "FIC Trip Silk Yes' Yo " <br /> LABORATORY DP COC RoY 1 7J5M2 <br />