Laserfiche WebLink
i <br /> CHAIN OF CUSTODY NO.O 71 v 8 6 Page _I_of <br /> CONSUf ANT'S NAME ADDRESS CITY STATE ZIP CODE <br /> BP SITE NUMBER BP COR ADDRESSICITY CONSULTANT PROJECT NUMBER <br /> CONSULTANT PROJECT MANAGER PHONE UMBER rr FA UMBER f` CONSULTANT CONTRACT NUMBER <br /> BP CONTACT ` ` 2 w�� � ��J I� 2-0 <br /> BP ADD4,. P E NUM !R FAX NO, <br /> LAB CONTACT LABORATORY ADDRESS FAX NO <br /> �1 PHONE NUMBER <br /> 1 -e-f <br /> SAMPLED BY(Please Print Name) SAMPLED BY Si nature) SHIPMENTpATE SHIPMENT METHOD <br /> e- <br /> C-05PtL -C_ H/Z3 <br /> TAT: 24 HoursAl BILL NUMB <br /> 1148 Hours ❑ I eek Standard 2 Weeks ANALYSIS REQUIRED <br /> n <br /> COLLECTION CONTAINERS PRESERVATIVE <br /> SAMPLE DESCRIPTION DATE MATRIX <br /> SOIL/WATER NO TYPE LAB COMMENTS <br /> COLLECTION <br /> TIME (VOL.) SAMPLE# <br /> )L l <br /> 3 i <br /> 5- S <br /> Z <br /> RELINQUISHED BY/AFFILIATION DATE TIME ACCEPTED BY/AFFILIATION DATE TIME ADDITIONAL COMMENTS <br /> PK Distribution:ts�zzz <br /> Prcr� White-Original with Data <br /> so Yellow-BP ( ) Pink-Lab <br /> Blue-Consultant Field Staff <br />