Laserfiche WebLink
s1 sit Its sit sit tiilililili� r_ ttw MONSOON <br /> ASSOCIATED LABORATORIES <br /> 806 North Batavia ■ Orange CA 92868 <br /> Chain of Custody Record Phone (7I4) 771 69QQ Fox (714) 538 1209 <br /> Company 7i2i-i t 01 1, a Pho � f� �j 7�� A A L Job No � L��� �� Page of <br /> Protect Manager FaxC , <br /> U ! rjU��-cP�- (;51(lL 1j,C Analysts Requested lest Instructions &Comments <br /> Protect Name Prot t M <br /> V�tvi-v--t elt& L 4. <br /> Site 'Tand Name t� t�L. (L A � ~r <br /> Address 1 { rj^ <br /> 12 <br /> Container <br /> Sample ID Lab ID Date Time Matrix Pres k <br /> Number/Size <br /> 2 t lel►-�t,r Fr�� �� �'�, �Z �� �- 1�-1? ,�7�a L��. �,��,1� � . <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 — <br /> I � <br /> r <br /> 9 <br /> K <br /> 10 <br /> C <br /> 1 <br /> 1t <br /> Y <br /> T2 <br /> 13 <br /> 14 <br /> 4 <br /> 15 <br /> Sample Receipt-To Be Filled By Laboratory sampler <br /> byC1 _ t Reunqul�hed bar .�2 Relinquished by 3 i <br /> Sam ler 2t - (!'K ) <br /> Total Number of Containers 2 al <br /> Property Coed Y I N/ A Signature Signature Signature <br /> k <br /> Custody Seals Y N NA Samples Int Y/N/NA Printed <br /> ttm fw � Panted Name Panted Name <br /> ed� <br /> Date Time Date Time Date Time <br /> Received in Good Conddlo Y J Samples Accept Y/N 1 7 t <br /> Turn Around Time Recened ey� � (fir Received By 2 Received By 3 <br /> Signature Signature Signature � <br /> _/ <br /> El Same Da ❑48 firs <br /> lid Normal LJ Rushy Printed Name Printed Nam ��,�& � Printed Name <br /> ❑24 hrs ❑72 hrs <br /> Date Time Date I� Time Dale Time <br /> r r ann Whrt, + ih� Ilan !'�n n I�hnnt-^ ink PrnlnrllArraunt ft in inrr G^ r^ I I' —I rIry III i f <br />