Laserfiche WebLink
C 0WHILL <br /> QUALITY ANALYTICAL LABORATORIES CHAIN OF CUSTODY RECORD AND AGREEMENT TO PERFORM SERVICES <br /> CH2M HILL Project <br /> �tw ^T'�. Purchase Order ati LAB TEST CODES .i SHADED AREA—FOR LAB USE ONLY <br /> i;L Lab 1# Lab 2! <br /> Project Name <br /> i <br /> Company Nama1CH2M HILL Dffl � a�_ <br /> KR Request# <br /> _ 0 <br /> ProManager&Phone# Report Copy to: ANALYSES REQUESTED ProJ�Ol + •,fyk"y t� <br /> Mr. <br /> C <br /> Me.i , I # h an <br /> Requested Completion Date: Sampling Requirements Semple Disposal: N v1 j No;of Samples 'PapF aDU `}' <br /> BDWA NPOES RCRA OTNER D1313088 Return A <br /> Type Matrix E i i I i COC Rar Login L1fYS Ver Ack den <br /> Sampling C A W S CLIENT SAMPLE ID S I i U1. <br /> 'O R A OM A T I (g CHARACTERS) �fi{i ! ! �, ,r. ' :.. <br /> 1 I ! -AW 2. <br /> P B E L REMARKS [I'D;,if. LAAO:2. <br /> Date 'Elms R <br /> AV <br /> N. <br /> 4 <br /> V { <br /> 1105 S/ <br /> .. <br /> _ 1 <br /> i <br /> �1 y <br /> }} K <br /> S m I By Tit (pt ■.atgn and p;r 1 D to me 2 Relin ul hed By (Pteese atgn aad print nems) D e me a <br /> [' ' HAZWRAPINESSA: YT; <br /> R8 IYB (Ple"a sign and print name ! �7 <br /> y g P 1 DateMme Relln Ish By -- (Plea"■Ign and print narM) I?atelTime QC. Leash;'1 2 k <br /> Olhalti;' <br /> COC fisc 's , ice <br /> Received By (Parse sign and pDater)ime . Relinquished By (Plea"sign and print narrai Datemme Arlo <br /> 1 print na nal a Req ' TENP •, <br /> Cual Seal a Ph <br /> Re vedgn and print name) ++}}�� DateMme Shipped Via Shipping M I <br /> Ir 7 dof f.J UPS U Fed-Ex Hand Othe <br /> IlikorkAtirthorlzed <br /> By (Plasse sign and print rimil no arks <br /> i t—•� PrrhLi6 & ti CaUi•t(?,M A1V*vy4i5 IN q-}t g,f�4VOIAA . <br /> Instructions snd Agreement Provisions on Reverse Side nrsrRrsuTroN:oRrorlvAt•tea,v.11ow•tie,Pink•CIlenf <br /> nFV 11192 POW 140 <br />