Laserfiche WebLink
tuck JJ,.t_ .jUi I L U C b U tS <br /> CONCORD, CA 94520 AND ANALYSIS REQUEST �i <br /> � ,� (510) 685-7852 <br /> i• L�sos�rosrEs, iwc. (800) 423-7143 F } <br /> Commy Name: Phone : <br /> ° <br /> ❑ <br /> L FAX a: ° � z ° ❑ <br /> Company Address: Site location: CID <br /> ❑ ❑ ❑ V Ir ❑ <br /> Con uib C 11 V(LOIS ❑ c r cCq a ❑ <br /> Project Manager: Client Prajeci I : (# C D� MZJ3-02o5 p W U1 2 Y ± ❑ h <br /> �n �`' cn y ❑ m <br /> V� n NAME 4• - T T N [ m ❑ ❑ ❑ ❑ ❑ <br /> I a teat that the proper field sampling Sampler Name(Print): 0. A ° ° o _J a v cQv <br /> procedures were used during the collection n o <br /> •, o ❑ N © °o a- C ❑ d 0 Q <br /> of these samples. N o u a� 6 � U 'R o o © � � ❑ o_ O � ❑ ^ 3 <br /> Matrix Method Sampling � �* p ra- a a o co p °� _` " $ ❑ LL <br /> m Preserved �, o T ❑ w w -1 <br /> Field GTEL yy CL a E] ❑ ° <br /> Sample Lab # CJ <br /> a ° ° ° ° w � � J � <br /> c w R ,y } o o x y ai Z <br /> ID (Lab use only) c°� o o W o o w w ;? o R a- Co `d co `� `�` cn o a_ c <br /> a p 2 U Z z �d a F- p } — a o a a a a a a a Q. lU a ¢ m o <br /> 3 in a w a 0 x x r _ oN o r- Co m z x O F- w w w w w w w w w r w ca o v <br /> W • <br /> cc <br /> TAT Special Handling SPECIAL ETEC ON LIMITS REMARKS pz) � <br /> Priority(24 hr) ❑ GTEL Contact <br /> Expedited(4e hr) ❑ Quote/Contract N <br /> 7 Business Days ❑ Confirmation N <br /> SPECIAL REPORTING REQUIREMENTS Lab Use Dnly, Lot q Storage Location: <br /> Omer PON <br /> Business Das ❑ <br /> OA I OC LEVEL <br /> BLUE❑ CLP❑ OTHER FAX❑ Work Order p <br /> Relinq 1 hed by S pier: Date Time Received by: <br /> CUSTODY Relinquished by: Date Time Received by: <br /> RECORD Relinquished by: Det Time Rece&94Labdratory: <br /> Rev.7191 <br /> Waybill 0 <br />