Laserfiche WebLink
3 16 KL1 EINFi ELDE! R i 1 ( 1 <br /> PROJECT NO '[ //� ``�� PROJECT NAME RECEIVING LAB: <br /> V,V I NO TYPE <br /> L P.NO SAMP�jRS:(Sign Num <br /> (PO NO // OF OF �y INSTRUCT]ONS/REMARKS <br /> CON- CON- <br /> DATE SAMPLE I.D. TAINERS TAINERS X21 <br /> TIME SAMPLE I D" MATRIX Vu <br /> MM/DD/YY HH-MM-SS <br /> 2 5o In 0 <br /> 3 <br /> a <br /> 5 <br /> ti <br /> 8 <br /> 9 <br /> 10 <br /> 11 <br /> 12 <br /> 13 <br /> 14 <br /> IS i <br /> 16 F <br /> 11 <br /> Id <br /> 19 <br /> 20 <br /> FRZefinquiedi (Si ) Datef ime Received by.(Signatu(e) Instruchons/Rernwks. Send Results To: <br /> " e __ � ) I L (/ ,1 KLEINFELDERtnqu�st e h :( Ignalme) Date/Time Received by.(Si -RAU.) 2825 EAST MYRTLE STREET <br /> y STOCKTON, CA 95205 <br /> Li <br /> (209)948-1345 <br /> Relinquished ny:(Signaturo) Daie/Timo Received lot Laboratory b ig a re Alw <br /> M 60 White- Sampler Canary-Return Copy To Shipper Pink-Lab Copy <br /> CHAIN OF cussronY N2 2137 <br />