Laserfiche WebLink
FA <br /> *' a—in-of Custody Number: <br /> SECOR Chain-of Custody Record <br /> Field Office: 50-%A �`/ 5 (coo � Additional documents are attached, and are a part of this Record. <br /> Address: =11 r �a tt �iT(n� Job Name: 7owe,- RL,* l`i�✓ ,'a 4 <br /> Location: 9Gt? l Ves <br /> Lod CA <br /> Project# (75C?T 0292b.ou Task# 67203 Analysis Request <br /> Project Manager �-V_CrJ Dgng �- <br /> Laboratory t rek"c-J£c o 0o W v d <br /> Turnaround Time 4+Gu�an� <br /> m0 w <br /> m cU 0U U -° O <br /> c 2w O ° 2r . mm <br /> av amJ <br /> U <br /> ame d W o <br /> a oSampler's NE Np0o> amo 2 <br /> Sampler's Signature E o 3 <br /> EEh o z Comments/ z <br /> Sam le ID Date Time Matrix =m yOaW Instructions <br /> W- 2 -�S oz 3o ref b A x <br /> M W- .25•Cal 0 14, 0 x x 4 <br /> Special Instructions/Comments: Relinquished Received by: xe4 Sample Rece pt <br /> Sign 76'+ Sign /qua cam– Total no.of containers: <br /> TP (fid 179 PrintPrint Chain of custody seals: <br /> H Company S C6n Company Rec'd in good condition/cold: <br /> Time Date Z Time 4g_� Date I 1p#14 7 Conforms to record: <br /> Relinquished by: Receive y: Client: <br /> Sign Sig <br /> Print Wt Print D 1 Client Contact: <br /> Company z- S• " Compan <br /> Time T3��Date Tim DZDate-4,2= Client Phone: <br /> SEGIXi CiU$TFECi Fev.l/99 <br /> Date: 9 1,26" / O.Z Page_L of <br />