Laserfiche WebLink
2795 2nd Street, Suite 300 <br /> Dav16 <br /> Jrt��J� LablS5 OA29764800 <br /> TICAL ecc Fax: 530.297.4808 Lab No. Page of <br /> Project Contact(Hardcopy or PDF To): California EDF.Report? ❑ Yes o <br /> RI CFS- J6f*i sa 1J Chain-of-Custody Record and Analysis Request <br /> Company/Address: Faaonn.p Oodbltnot niawlaftxy m comphae dissectlors <br /> Sampling Company Log Code:A-PFCEivVI�TFC linComanLCdAnalysis Request a <br /> Phone No.: FAX No,-, Global ID: <br /> m 1 X <br /> � C> <br /> r� eq m oProject Number: P.ONo: EDF DON o mall Address): M N Xw <br /> >'l]� Vm,VO e coProject Name: Sam N a <br /> Ile Q• <br /> I f�i I"Gi1 <br /> 00` <br /> CO <br /> n <br /> Project Address: nSampling Con ner Preservative MatrixCIS t N <br /> CO v m� fGAm O <br /> xep <br /> O0 ; T�GN6 <br /> C3 R p ��m9 Cm y 8 o = N c` U. <br /> en Ell Q X F- W L4 U O� o° �Oo„ T (� pAID CO Np m N <br /> Sample Designation Date Time � �- z m z ` F o a o o m > m <br /> E-F� ,5:9-03. f 1.3o o i <br /> 08- AJ0 <br /> 1 <br /> Re nq !shed y:. Date Time Received by: Remarks: <br /> /� <br /> Relin ish y: Date Grime Received by: <br /> 30 <br /> fished by: Date Time Received by Laboratory: Bill to: <br /> Disfdhution: White-Lab,Yellow-File,Pink-Orlginefor lo, Forms/cm 121001.M9 <br />