Laserfiche WebLink
" fRoAl allWaMaMWa1-ic", It= mokepm -�- �■■ <br /> -.. Regulatory ❑ Yes ❑ No CC: ❑YeW No <br /> 1405 Kansas Avenue, Suite "A" Phone: (209) 572-0900 <br /> Modesto,CA 95351 Fax: (209) 572-0916 Regulator: <br /> Phone: (tel <br /> Client: W.H. T,,h)C— CHAIN OF CUSTODY Fax: ( ) <br /> Address: Q - W7 Original To: d <br /> city Q? cf1- zip. �S >�j ti� N C' <br /> Project ID — tip[d A? — ` Lab Use Only <br /> {Print N .-L-ab <br /> ---_�_......._..-�----...__.._ .. <br /> Sampled By ZFL� e fl <br /> (Signature) 'y <br /> Container <br /> Sample typeLab ID# <br /> Sample ID z <br /> Date Time Crab Comp Matrix p Type L I py <br /> 0: W MW m3 M <br /> Remarks! <br /> Ulf — i <br /> 86M1 ' <br /> 9 <br /> -- <br /> 3 <br /> i <br /> Remarks <br /> Relinquished by{Signature} DateTime Received by(Signature)_ Date Time <br /> Relinquished by(Signature) Date 'rime eived by(Signa ure) ate Time <br /> Preservative Matrix <br /> Q-4°C Q-HCL Q-NaOH Q-Na2S203 0-HNO3 Q-H2 S O4 Q-Other Drinking Water GWaste Water®Hazardous Waste (Water) QSoil/Solid <br /> Site Time: Driving Time: Time Mileage <br /> Start: Finish: Total Hours: Start: rSite Arrival: x2=Total: <br /> Turnaround Time ❑Standard ❑Silver Rush ❑Gold Rush OPlatinum Rush ❑Other: Approved By: <br />