Laserfiche WebLink
i <br /> be <br /> L-Tecii <br /> SAMPLE CHAIN OF CUSTODY RECORD C)fen! <br /> serpr�olt Si'rvieea AddressDI C o� c, U� <br /> (Please Prinl) P(30118�0. ILk . <br /> IT24 lXiva Avenue <br /> Oakdale Cabl. 95369 Prof•M9000MOC1 I L.L <br /> (203)847.8757 Plnk-Ftatd Copy � a <br /> Record o1 Whlla end Yellow-To labor2l 'd <br /> �0.1ECTISITE ME- <br /> yell— <br /> hIA . aY wlth Samples <br /> `f 111 a t�Q s ntttC5�1111_ Rstum to Ghent <br /> ET tiLb At) n1AN Cr o ' <br /> ANALYSIS REQUESTED <br /> PROIEONTRACTrPO NO <br /> NAME OF SAMPLER © <br /> a <br /> LAS USE ONLY C7 REMARKWSPECIAL INSTRUCTIONS w <br /> SA1�IPLE d <br /> LAD to d m NUMBER 'O U <br /> 1.0. DATE TIME a� OP (nom / Ljj' <br /> INEUS <br /> � x <br /> 11 W Vi <br /> x <br /> f,E SLlL l <br /> 916 4 � <br /> -7 <br /> MBILL <br /> s <br /> GE C <br /> i <br /> 1 <br /> REL1NOt1lSFlED 9Y S113N DATE/TwE � <br /> •, �� ll2 RECEIVED BY IGN <br /> bi <br /> DATE:TIME RECEIVED FOR <br /> a / LABORATORY <br /> BY(S1GNp._ <br /> DATErTIAIE___ <br /> RECEIVED: <br /> Q <br /> CLD AND It <br /> rTA a <br /> GT OTHER PRESERVATIVE fJY <br /> �—� ES <br /> f1N <br /> OOTHER; O <br /> SHIPPED YiA. gFED X L]UPS �OL—T�<�i� - -�_ TURtr AROUND TIME.- <br /> SHIPPING <br /> IME:SHIPPING ORDER <br /> ❑2 He 02 My 0 Day in Day <br /> I El <br /> i <br /> I <br />