Laserfiche WebLink
D V D E Chain - of - Custody Form Form <br /> 605 Third Street 7 Laboratorv: Lab Job#_ <br /> Encinitas, CA 92024 Lab Contact: Shipping Method: <br /> Tel:760-942-5147 Project Manager: PM Email: <br /> Fax:760-942-5206 <br /> @dudek.com <br /> Project Name: Job Number: TvDe of Anal sis to be Performed TAT Special Instructions <br /> t f v ( 0 0 0 0 <br /> .c <br /> 00 00 00 00 N <br /> Sampled by: Sampler, i�natrure00; Q, <br /> 00 <br /> � C L <br /> O <br /> Sample Collection Matrix Method Preserved q umber of Sam o le Container o ¢ N <br /> Z E b o <br /> W Q C7 0 c v <br /> O Z ° b <br /> E <Cx <br /> Sam le ID Date Time 3 c° x ii 0 O> of Q O <br /> U H O CIO O <br /> Total# of containers per type Total#of containers Please return original COC to Dudek <br /> Relin uished by: Com an Dat Time 'Reeeed om an Date Time �7 S m le Recei t <br /> f, /`«.�e7,4,4/ a ��j� lav/ ❑ Samples Intact <br /> ❑ Cooler Temp: C <br /> ❑ Conforms to COC <br /> P—11/15 <br />