Laserfiche WebLink
Calscience Environmental Laboratories, Inc. CHAIN OF CUSTODY RECORD <br /> ❑ SoCal Laboratory ❑ NorCal Service Center ill <br /> 7440 Lincoln Way 5063 Commercial Circle,Suite H Date 2U / <br /> (� <br /> g Garden Grove,CA 92841-1427 Concord,CA 94520-8577 <br /> (714)895-5494 (925)689-9022 Page / of I <br /> LABORATORY CLIENT: CLIENT PROJECT NAME/NUMBER: P.O.NO.: <br /> A(4DU n&tr- <br /> ADDRESS: M <br /> 7J Nr t'/ !leI'VO PROJECT CONTACT: /' :n- <br /> LU <br /> CITY STATE 21P �Lr-. G Y�./�`�C� EQ ED I.A. IT ®. <br /> SAMPLER(S):(PRINT) COELT LOG CODE COOLERRECEIPT <br /> TEL' E-MAIL: 1 TEMP="' <br /> 1 - 3Gt7 b . A, ru �i —4/j. °�cr. /")c./Cr , FEl <br /> °c` <br /> TURNAROUND TIME: - <br /> ❑SAMEDAY ❑24HR ❑48HR ❑72 HR X5 DAYS Ll 10 DAYS REQUESTED ANALYSES <br /> SPECIAL REQUIREMENTS(ADDITIONAL COSTS MAY APPLY) <br /> ❑RWQCB REPORTING FORMS ❑COELTEDF ❑ _ <br /> SPECIAL INSTRUCTIONS: v b <br /> m <br /> o <br /> _ o Q a <br /> w• <br /> LUZE <br /> m o <br /> LnE- .FIELD POINT NAME SAMPLING NO.. i i m w U am. $ O 5 m `� � > U m <br /> USE SAMPLE ID (FOR COELT EDF) MATRIX OF a ti m O W y a a d U �j H <br /> ONL' DATE TIME CONT. <br /> 2 S'U-3 3 <br /> 011T S <br /> -S- Cof Xrs / <br /> N <br /> O <br /> f` <br /> W <br /> Relinqu' a by Signature) Signature/Affi' 'on) Date: Time: atu <br /> !/ qo o8 /o,?z?, 9 <br /> Rein d b igna r Received by:(Sign ure/Affilia' n) Date: Time: <br /> Relinquis a by:fTignaturl <br /> Received by:(Signature/Affiliation) A Data. Time: O <br /> / I/ Zl B /!% `o <br /> y r+I�T�f�TION:White with final report,Green and Yellow to Client. 10/01/07 Revision <br /> Please n to that pages 1 and 2 of 2 of our TfCs are printed on the reverse side of the Green and Yellow copies respectively. <br />