Laserfiche WebLink
4080 PIKE LANE, SUITE c MAIN-OF-CUSTODY RECORD �. <br /> IGTEL CONCORD, CA 94520 AND ANALYSIS REQUEST 1'2 6 5 <br /> (514) 685-7852 <br /> 1.,n,.re,E (800) 423-7143 1 1 <br /> Company Name: Phone#: s' i�x-,;,o <br /> FAX#: � [� :S'�i> �3 / ❑ e ❑ <br /> a ❑ <br /> Company Addres Site Location: 17r5-!5—!�'�s► m [D ❑ 0 <br /> � 7�r�al d/ sri 1, ❑ ❑ ❑ H d <br /> r w o n n a ❑ co <br /> ❑ <br /> Project Manager: Client Project ID: (#)p+�yva•J Y + ❑ ¢ <br /> v b Cr Y'fe/ti7� M s9[i1i f 6�r. m �_ o ❑ ❑© C1 z z ❑ ❑ G <br /> j 1 attest that the proper field sampling Sampler Name(Print): ❑ ❑ N _ o a ❑ E ❑ <br /> � � 4 " ❑ ❑ U1 ❑ O J J b O O -.j � <br /> j procedures were used during the �j fllL }fin y���y17�?� r- 0 a co T N E1 ❑ a a `2 a° � 0 4` <br /> collection of these sam les. /�� 0 ❑ v ❑ 0 o o o N ❑ <br /> ❑ a S N c n ri ¢ ❑ <br /> Method o °' m m ¢ ❑ ❑ ° o <br /> I I GTEL W Matrix Preserved Sampling ❑ o w ❑ ❑ � -9 a ❑ <br /> n N ❑ <br /> Fled z M ❑ o a s ca ❑ <br /> z ~ ❑ m ` m o r ❑ ❑ D a o_ D y '`o N <br /> Sample Lab# a W c� o ca Ln M N � o v �; <br /> ID /Lab Us o f °o Cr o o rr 0 o d ro b <br /> l // 0 w ❑ W cc wr w x �Z i <br /> j only V ¢ p ¢ cc r U z `� v zw ON a F > > m a o a a- a a a a a d v a a a o 7� <br /> at [A d Vl d O Z Z 2 — a" O,. ❑ F m m T Y O fT W W W w W W W W ui F W U J O U y <br /> 44 7i Oz <br /> ' ey 0 3 <br /> 04 <br /> f a k x a <br /> 5 <br /> its ' y �'�•' T- ., r �_ V t5ra .x .ci'._ t e d r- _> P.�3 <br /> ii <br /> r k <br /> thVl:z ` %a 1� §"r <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS:/„���p�� ����„ � � �7-�r> <br /> Priority(24 hr) O GTEL Contact 1 <br /> Expedited(48 hr) D Quote/Contract# <br /> ��PT� � r�e� us• �� � <br /> 7 Business Days D <br /> Other Confirmation# <br /> Business Days 13 P.O.# SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot#: Storage Location <br /> QA/QC Level RJ( IME-2(40 <br /> YED <br /> eiue Ll CLP❑ Other❑ FAX❑ Work Order#: DATE"I <br /> 0 <br /> Relin uishe by Sam er Date Time R ' ed by: TEMP <br /> CUSTODY f ` 1630 <br /> Relin h d D Time Received by: <br /> RECORD 11 10(97 II+#o <br /> WEST FAQ <br /> tRelinquished by. Date Time Received lyLaboratory: <br /> Waybill# <br />