Laserfiche WebLink
Phone# 916- 500 <br /> f!/ 1046 olive Drive, Suite 2 Fax# 916-753-6091 CHAIN-OF-CUSTODY RECORD AND ANALYSISVQUES7 <br /> Westem Ewronmental Davis,CA 95616 Sample Receiving# 916-757-0920 <br /> Science&Technology <br /> Protect Manager Phone# ANALYSIS REQUEST For <br /> Rr6 -6 7f-Y7-r-3 Use <br /> Company/Address FAX# a t 6-6 `7 e-/4 PEI NET (A ONLY <br /> >n <br /> L wArr1 $OS 1V iLlNCgt. N Sk irE D[ and t RS6 Z D m Ta�� <br /> Protect Number P O# Protect Name x <br /> 0o T4-7 T2U[ u, <br /> Sam ler Signature o ,� o E <br /> Protect Location PL <br /> � � m <br /> c o m z <br /> Logi .� � _ as NQz <br /> Container Method N a � o o a o o T9 � � o � <br /> sampling (Type/Amount) Preserved matrix <br /> a w d o m v ti d C <br /> m N +-' O p Q N N 1' <br /> O c` co m DO a0 N bS <br /> Sample ID <br /> 'q in <br /> wv� Cn w oaa � � o QU o <br /> DATE TIMEa � O z � -J '� ' = raaaaa � <br /> V Z w O a0 F- 1-- aaaa. a- a. (L � � N <br /> j 1 a = = U Z � � maari- wwwW W -J <br /> V/ T <br /> l 0 0 K K <br /> 34 1 t - S S qo K <br /> 3681 { —Sb 131-7 X <br /> � <br /> S $ 133 '{ X <br /> -S X 167,0 X K <br /> -�, alt - si o 1630 <br /> ?S 17 i c -S r [ 16 40 <br /> - ScZ <br /> � t <br /> Of r -st4 1779 <br /> x K <br /> Relinquished by Date Time Received by Remarks <br /> u <br /> Relinquished by Date Time Received by <br /> Relinquished by Date Time Received by Laboratory Bill To <br /> rfil <br /> �e� <br />