Laserfiche WebLink
1046 Olive pave, Suite 9167539'001 <br /> 167539500 CHAIN-OF-CUSTODY RECORD AND ANALYSIS R UI ST <br /> weslern Env,ronnr�,nr.r, Davis, CA 95616 FAX H 916 753 6091 <br /> SCIenC@6 Technology LA BU 916 7574650 <br /> Project Manager Phone It <br /> 1 e M 7- 1 C- 3?? - /9 31/ ANALYSIS REQUEST TAT <br /> Company/Address FAX# WET (r) <br /> a3u t�Sar�w ' �/� / Vb S ui TOTALJ,-► 3 <br /> Protect Number P O 9 Protect Name <br /> 16 2C N ul <br /> Cr k. e rC3m fu Y <br /> Project Location SArnple gnature m <br /> Sta G v C � V) L) w j ccN _U _U <br /> Sampling Method N b - a s . N z �' u m <br /> Container N a N v <br /> Sample Matrix Q „ �, �_ o Q Q d o o a v <br /> Preserved � W . (5 N N V) CD GO 'q � �u U n > <br /> 1 w U o a a p ll w fr <br /> ao a m ro W U a cdv N CC O <br /> DATE TIME u}i `t N u, w `D h p O o 0 0 .n m CO N N z v a <br /> a w a O z i- J x X ro m = �O `A v7 W m w In ¢ 0 = C] <br /> O J a z u' o a p w w Q a a a s a s M a Q N a z <br /> of J S = 0 z N 1- i- Q o o co a a a a a a a a I 4 Q. lu 13 a <br /> - m }- F w w w w w w w O X U w J (] � W <br /> �►. ,..� - Z 1z �- 1216 3 � ! - - X_ — ,r - - - — — — - — — <br /> r't- w _ 3 11; 7 -- -- — - - — -- — - <br /> tri J <br /> ...... Attl--- —I—— <br /> LR02 ed by -- Date Time Received by Remarks <br /> 1 Z 1 3 l 3 'P-v j T6 �' ,tee 1 's IS <br /> Relinquished by Date Time Received by <br /> Relinquished by nate Time Receive Laboratory gill To <br />