Laserfiche WebLink
. AssoCUM LMORATo <br /> Chain <br /> 806 North Batavia • Orcinge, CA 92868 <br /> Custody Record Phone (714) 771-6900 ■ Fc�t {714} 538-1209 ZLM\ <br /> Company-rr,ri a r <br /> j Phone( <br /> Protect Manager ��� Fax 64 �� � � A Job No L Page of +' <br /> Analysts Requested Test Instructions&Comments <br /> Project Name V Project# <br /> and Name ca <br /> +'(a y /i�� C V `c b �.. <br /> Address Qo <br /> Sample ID Lab ID Date Time Matrix Container <br /> Pres <br /> Number/Size <br /> T ' <br /> 9 V I LIF�r �i'-oo —1r'�f} 1*GL <br /> +Kr-A 4 -Vt/4 14- <br /> 4 • ct- X <br /> 7 <br /> a <br /> s <br /> 1Q <br /> t1 <br /> t2 <br /> 13 <br /> 14 <br /> 1S <br /> Sample Receipt-To Be Filled By Laboratory Relinquished by 1 Rehriquishad by 2 Aelinquished by 3 <br /> Sam ler I�.I'f.C �p(�p�N( S] �y <br /> Total Number of Containers Properly Cool Y!N/NA SignaeQr a Signature Signature <br /> Custody Seals Y/N/NA Samples Intagf /N/NA Printed Name Panted Name Panted Name <br /> cYy A14 <br /> Received,n Good Condition Y/N Samples Accept Y/N Dat Time -� Date Time Date Time <br /> Turn Around Time Recei ads 1 Received By 2 Received By 3 <br /> Signature❑24 lits ❑72 lits Printed <br /> Signature V / Signature <br /> ❑Same Day U 48 hrs O V�q I <br /> Normal LlRus f] Printed Name Printed Name Printed Name <br /> 4I� �,� <br /> Date Time Date Time D to Tine <br /> 0— I : 4 / <br /> Distribution White Laboratory Canary Laboratory Pink ProteoVAccount Manager Goldenrod sampler/Dnginator <br />