Laserfiche WebLink
DGM <br /> ENVIRONMENTAL, INC. <br /> BULK SAMPLING I CHAIN OF CUSTODY FORM <br /> Project Name , ���? _ Collection Date l Pg �_ of <br /> Specific Location o _ Project# 0/-35-4l W O # <br /> Technician Method of Anal rysis Method of Analysts, <br /> -orm /)Pt count RUSH < 2 HR <br /> Laboratory 37 Matri Bulk Wipe ! Paint / Water / Soil TEM - qu quant < 12 HR <br /> AA/Flame - 4 HR <br /> Stop analysis if any sample within group 2J Y/ l/1Q°[o�'LN__Composite Sheetrock Y /N DAY <br /> Sample # Material Description Location <br /> H # Job # Count Material Type Description Color General Room Specific <br /> 3tS�1too Oe r/I{ a Ct9 4ti r wn <br /> Rehnqui�hed byRAY)IKIYDate/time r U� Received by Date/time <br /> Rel► qwg hed by Date/tune Received by Date/time <br /> 5460 Caincaion Surte 102 Las Vegati, NV 99118 1 Tel (702) 270-2461 I Fax (702) 270-2487 I dgmentCd)aol Lone <br />