Laserfiche WebLink
i I <br /> Pace4knalytical CHAI90E-CUSTODY 1 Analytical Hequest uoent <br /> The Chain-of Custody is a LEGAL DOCUMENT All relevant fields must be completed accurately <br /> The Right Chenusoy, The Right Solution" 493719 <br /> Required C11En1 information Section A Required Client inlormalion <br /> Section B page 2,, of Z To Be Completed by Pace Analytical and Client Section C <br /> Toy� <br /> Report Ouole Reference <br /> Campanl <br /> CiienlInlormabon Check uolelconlracS <br /> Address y, r <br /> Invoice To Requested Du Data TAF Project Manager <br /> l� PO O •Under 14 day turnaround subject to tabwalory and Project k M <br /> contractual obligations and may result in a Rush V <br /> Project Name Turnaround Surchafge Profile u <br /> 130 U Tum Around Timo(TAT)in calender drys <br /> Requested Analysis I <br /> Ph Fax Project Number <br /> D <br /> VOIL ;�Section D Requ[red Chen!lniormahon o PreserVatf OS l w w WO F UwSAMPLEID ° <br /> WIPE VIP X <br /> One character per box AIR AR o o a a O _ O <br /> (A-Z,0-91 -) TISSUE TS a ° Remarks 1 Lab 1D <br /> H z <br /> Sample IDS MUST BE UNIQUE OTHER OT mm l dd l yy mm hh alp u _ = <br /> y <br /> rv - D <br /> w I o <br /> w <br /> ti + <br /> i <br /> .{{�� } L I <br /> jCr li "Csh� l �� i'++ <br /> Accepted By Company <br /> Sample Condition <br /> i <br /> 1 b lc <br /> Temp to°C 4:qz 11,0-77 <br /> Received on ICE Y 1 N <br /> Sealed Cooler Y 1 N <br /> Samples Intact Y / N <br /> SAMPLER NAME AND SIGNATURE <br /> Additional Comments PRINT ame of SAMPLER <br /> L� <br /> SIGMA RP�oI SAM � DA�Siqnet I M/DD r J'r) <br />