Laserfiche WebLink
CHAIN OF CUSTODY RECORD BCA Log Number <br /> Analyses required <br /> Project or PON , <br /> ien{t���Q'Je q30 — <br /> Idr? 7-O w Q <br /> ty,State Zip W >`1 v Phone N� <br /> ��) AA '' G �y / 2 Report attention <br /> D � <br /> Type' Sampled by g n' 1 r 'D Number <br /> Lab �jM V of <br /> ample Date Time See key containers T Remarks <br /> rmber sampled sampled below Sample description <br /> q�2o�9p GW STGKe I 9001 13 Zo3 Z V/ <br /> y S T k o 00q I z o '-I Z- ✓ <br /> 013 Zo 5 Z- <br /> - 1 10011,7-0& Z-. ✓ <br /> k L 09I3ZOO- -7- <br /> c- 900913209 Z <br /> Si nature Print Name <br /> Company Date Time <br /> Relinqwshedby <br /> Received b � <br /> y� �h a ,� ti�t ►n, �-� <br /> Relinquished by <br /> Received by <br /> Relinquished by <br /> Received by Laboratory <br /> 8 C ANALYTICAL Note:Samples are discarded 30 days alter results are reported unless other arrangements are made. 'KEY. AO—Aqueous NA—Nonaqueous SL—Sludge <br /> Hazardous samples will be returned to client or disposed of at client's expense. GW—Groundwater SO—S011 OT—Other PE—Petroleum <br /> 1255 Powell Street,Emeryville,CA 94608 (415)428.2300 <br />_ Disposal arrangements: <br /> Bot Western Avenue,Glendale,CA 91201 (818)247.5737 <br /> 1200 Pacifico Avenue,Anaheim,CA 92805 (714)978-0113 <br />