Laserfiche WebLink
(�V <br /> 2nd Street, Suite 300 <br /> DaviDavis, CA 95616 <br /> ALYTICAL I L.c Lab: 530.297.4800 , <br /> Fax: 530.297.4808 <br /> Project Contact(Hardcopy or PDF To): Lab NO Page Z of Z <br /> California EDF Report? C�sl 1'es ❑No ^� <br /> �' sres. Chain-of-Custody Record and Analysis Request <br /> C/ompany/Address: �o�r�ran<sad t rtw, to "-c6— <br /> f,�ort`Za► rv/rb^�,,Q I samplIng Company Log Code: H <br /> Phone No.: r * F— Analys€s Request a <br /> FAX No.: Global ID: f- <br /> (q16� q��zt7p (C'(6�q�cl-V7 T 4 p 7 7Dp <br /> o g <br /> m m <br /> Project Number. 15 P.O. No: EDF Deliverable TaEmall Address)- m 3 <br /> m in <br /> Project Name: - _ w N <br /> Sa pler Signature: T m N a 0 <br /> Fuer acs C�,, IZy7y 1�. w a e 0. o a <br /> Project Address: $ c� o w. " - <br /> N U <br /> Sampling Container Preselvative Matrix m I; @ o - `° o N = a <br /> a a : CO <br /> L J <br /> E LU r- r C3N t 1L <br /> Sam Fe Designation �' ° Z ~ =' m Q m <br /> Date Time v t s �� z z a o a s a +7 0 M <br /> F F 4n n N W N <br /> ,c <br /> _: a <br /> SSI D-3 0:� x — - -% <br /> V r 6-ti-03 r7-s ,� K - 13 <br /> W >� <br /> IK '` '` x 1J <br /> Relinquished by: Da Time Received by: <br /> Remarks: <br /> Relinquished by: Date Time Received by: <br /> Relinquished by: Date Time R eived by Laboratory: - <br /> Hdl to: -- <br /> p(oara3 lro.w1o�>~ /� <br /> Oistriburion. White-Lab. Yelk w-File.Pink-Originalpr - Tp,�1 �01-1 <br /> t'4m19/CpG 1210e11h9 <br />