Laserfiche WebLink
4W <br /> J —1,..�J <br /> s <br /> KAPREAtIAN ENGINE EP ING I ' <br /> I N C o R P o R A T E 0 <br /> CIIAIN OF CUSTODY <br /> SAMPLER SITE NAME It ADDRESS ANALYSES REQUESTED TURN AROUND TIME <br /> WITNESSING AGENCY <br /> , t - <br /> ND p <br /> SAMPLE OF SAMPLING \ ` R E K A R K S <br /> 16 N0, DATE TINE SOIL WATER GRAB COMP CONE LOCATION �� <br /> fflw o l.130 x �o,� x K I DA��SA <br /> M W/3 tA <br /> Relinquish by: (S nate /D m e/Tine aed by St nam e) The following MUST BE completed by the laboratory accepting samples <br /> for analysts <br /> 1 Have all Samples r F ived for analysts been stored in ice? <br /> Relinquished by '(Signature) Date/Time Rec ived by (Signature) _ w <br /> 2 Witt samples r in refrigerated until analyzed? <br /> Relinquished by- (Signature) Date/Time Received by (Signature) 3 Did any samples ived for analysis have head space? <br /> 4 Were samples n ppropriate containers and properly packaged? <br /> Relinquished by (Signature) Date/Time Received by (Signature) <br /> t. innp � <br /> Signature Ttt a Date <br /> 2401 SMIRCH f hl",SUR 40) <br /> o"iturd (. 1&F o 19l5Z0 <br /> Ti1510(A)2511XI lix 510(00002 <br />