Laserfiche WebLink
I� 180 BLUE RAVINE ROAD, SUITE B <br /> AIR TOXICS LTD. FOLSOM, CA 95630-4719 <br /> AN ENVIRONMENTAL ANALYTICAL LABORATORY (916) 985-1000 FAX (916) 985-1020 <br /> CHAIN-OF-CUSTODY RECORDPag11102064 <br /> aof _ <br /> A � <br /> Contact Person M t r� by JZ 1 r 1} <br /> y O4Uns Protect Info <br /> Company G p A. CL Turn Around Time <br /> Address� e O P O # 6-:Normal <br /> Stat Z 27 <br /> Phone q�1 - y�/`l O!�-3 ` � -I � '7 A [v Project# El Rush <br /> Protect Name 3� Specify <br /> Lab FAX Field Sample ! D <br /> 1 D. P Date &Time Analyses Requested Canister Pressure/ Vacuum <br /> old <br /> tZ E F FL r1-3 2S T P#c <br /> T�x <br /> Initial Final Receipt <br /> tN,=z � <br /> TP PC 13 <br /> TE x <br /> FEEE <br /> Collected By: Print Signature <br /> DPt0 �`� Notes. <br /> Aelin a 11 re) Dat ime Receivenatur ) a im <br /> -4�y �zsd d By( � <br /> RelinciUshed By is re) Date/rune Recerm Sy'(signature) Date/rime <br /> i <br /> Relinquished By (Signature) DateTme R wed nature) telrvne <br /> 'Lab <br /> r; 'I�+ ShI r N ,ame x # O e patelT#[ne' S em .V Conditton CustodySeals Intac v Work Order# <br /> 4 W� <br /> Only <br /> n r F{J�ii�a� nn <br /> Oniy i _ t J�;1� �," i� l3 1� Yes I No / Non <br /> ' Tza3 rev os <br />