Laserfiche WebLink
. a r <br /> 0 Cham-of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 0 7 Additional documents are attached, and are a part of this Record <br /> Address !� �v51 N+S K .01Q , /o0 _ _ Job Name -11M 5 CSS L BOG K1.5 FO(Z <br /> C C� 9.S'��7 Location m000 L' � �. <br /> loe <br /> p- 0 <br /> Project#0 77. Yi,73 i oro-3 Task # Analysis Bequest <br /> Project Manager r;�:�j 4 Me., 4- � <br /> Laboratory— 4 o u Q <br /> Turnaround Time_ .f,� Nyrf,QD 02, <br /> d� �y m EUi> QU U <br /> �J / � °'dry <br /> Sampler's Name��\ 17'G/1rk rr'�o d U o 0 c o O o Tc� o <br /> Sampler's Signature o m�, �, = �� 'm J ti ro a <br /> U do as d °o oc�v roo�' �n �o o� CJ? Comments/ <br /> Sample ID Date Time Matrix z �- a a o ,- instructionst A <br /> Z <br /> 1 � <br /> Special Instructions/Comments Reknquished Receivby <br /> Sample Receipt <br /> Sign Sig , ' ; Total no of containers <br /> Printr -e - n_ Pn Xe Y ltnWgZ5 Chain of custody seals <br /> Company �l Ga Z_ Company e Recd m good condition/cold 1 <br />� Time Date Time LL Date <br /> /�-`'� Conforms to record <br /> Relinquished by Received by Client 4�F,:nQ <br /> Sign _ _ Sign <br /> Print Print Client Contact 1446w <br /> Company Company <br /> Time Date_ _ Time Date Client Phone <br /> SECOF ruS PEC lift 299 <br /> Date /t I a / 9 Pageof -► <br />