Laserfiche WebLink
` Now ..i <br /> E a s e c o Peso <br /> ( % CHAIN-OF-CUSTODY RECORD EXX?3Q-OLO�F�14�04 " <br /> v SAMPLER:(SighatpJj ` <br /> '>, Date Shipped Carrier + •" t�X •�a <br /> Phone 1=5� -Ly ---7--' " 7 Airbill No. Cooler No. f <br /> L SHIP TO: SEND RESUJ.TIS TO: <br /> Enseco-CalLab Client >v <br /> /< <br /> 2544 Industrial Blvd. CompanyjF' r' Nor <br /> West <br /> _ <br /> Sacramento,CA 95691 Addre.e_l// t-4F 4YFi rr: +- sir' <br /> bee (916)372-1393 7 ✓I FA fFi Tt= I L 4S 9 <br /> ATTENTION: -r-- Phone Lit) 2(3'�� "-- 7cU72 <br /> PROJECTNAME S I L's t`�� PROJECT NO. TXJ( '7-3 X2 P.O.NO. .-XX <br /> Relinquished,-by:� + n ture) Received by: (Signature) Date Time <br /> bee r <br /> Relinquished b, . ( i ature) Received by: (Signature) Date Time <br /> hea Relinquished by: (Signature) Received at lab by: (Signature) Date Time <br /> Relinquished from lab by: (Signature) Received by: (Signature) Date Time <br /> bee <br /> ANALYSIS REQUEST <br /> r Sample ID Sample Date/Time Sample Condition <br /> //�Number ( Descr/iption Sampled SS- /Analysis ea`wuest d Upon Receipt 111M �� S Sei+ / �7/�t( � �'7 / Jre.� ✓/t,'.$'lC�«-- <br /> t <br /> bee 10 5- 17 57 <br /> Ow6 17 s-' Z+ 73 7— ( <br /> r!W) 17.5 sa . / 7/(r, 37 k5 r 7 <br /> ` <br /> ti 0") 17 , l 7/IS <br /> e CJ 1.J C.Lt-.T CCL L <br /> Nee <br /> Special Instructions/Comments: <br /> 0- <br /> NOTE• UNUSED PORTIONS OF NON-AQUEOUS SAMPLES WILL BE RETURNED TO CLIENT <br /> Expected <br /> Analytical Immediate <br /> T.A.T's: _ Attention (200% surcharge) _ RUSH (so-t00% surcharge) A. Standard <br /> b- Cal Lab ID Number: (for lab use only) <br /> Client Retains White Copy Only (Revised 1/87) <br /> r <br /> le <br />