Laserfiche WebLink
(—, CHAIN OF CUSTODY AND <br />POSITIVE 7131 East Washington Blvd, ANALYSIS REQUEST <br />� Los Angeles, CA 90021 DATE --_ .-_ _ PAGE _OF <br />".1,1!: PF LA Q S C RV 1 C E (213) 745-531 2 FAX (213) 745-6372 LOG BOOK NO.__ FILE NO - _ __ LAB NO <br />n►J %' n <br />CLIENT NAME:1"C <br />�i/�10r1 <br />ANALYSES REQUESTED: <br />AIRBILL NO: <br />1 gc_rtrc. t�(1.�I c�c� <br />COOLER TEMP: <br />PROJECT NAME. PROJECT NO. P.O. NO. 1 C 0 <br />1� <br />PRESERVED: <br />ADDRESS: <br />O <br />c� <br />QC REPORT <br />LEVEL: <br />PROJFCT MANAGER: PHONE NO:(z13) 14S- 7- FAX NO: t.1) 115 631 Z <br />- -REMARKS: <br />SAMPI — <br />(Pnnled) ISnpsrlurel <br />.r <br />J <br />TAT (Analytical Turn Around Time) 0 = Same Day, 1 = 24 Hour, 2 = 48 Hour, Etc.) N = NORMAL <br />CONTAINER TYPES: B = Brass, G = Glass, P = Plastic, V = VOA Vial, 0 = Other: <br />" <br />SAMPLE CONDITION/ <br />SAMPLE <br />DATE <br />TIME <br />MATRIX <br />CONTAINER <br />WMEn <br />son Il-,_ <br />U111En <br />r <br />YE <br />NO. <br />SAMPLED <br />SAMPLED <br />SAMPLE DESCRIPTION <br />TAT <br />COMMENTS: <br />f <br />Pel sh, I By ISiynal, ind i'mAnd Name) Received By (Siyn:dure and Pnnled Namel Pale Bine <br />N i �`{J t '123 <br />SAMPLE DISPOSITION: <br />Q 1� <br />I. Samples returned to client? YES NO <br />2 Samples will not be stored over 30 days. unless <br />RL,hn(j,,,Shco By �0 ),alure and Pnnled Narne) Recoved By ISgyrdure and Pnnled Name) Dale T,me <br />additional storage time is requested. <br />By IS.ynalure and Pled Name) Received By ISignalu(e and Pnnled Wine) Dal. I ane <br />Rel.ngwshed nn <br />r <br />3 Storage time requeSterl clays <br />BY -- - - - -- - Dale <br />SPECIAL INSTRUCTIONS: <br />DISTRIBUTION: WHITE, YELLOW, PINK 10 LAB --GOLD TO CLIENI <br />