Laserfiche WebLink
iiftwf, 11111111111111111•�� �� �� �� �� sitrww : ttttttttttttttttti i� i <br /> 2795 2nd Street, Suite 300 <br /> .�� Davis, CA 95616 <br /> Lab 530 297 4800 <br /> ANALYTICAL c�c Fax 530 297 4808 Lab No Page of <br /> Protect Contact{H dcopy or PDF To) California EDF Report? ❑ Yes ❑No <br /> Chain-of-Custody Record and Analysis Request <br /> Company) ddress 6eQc pj7 Reoornmendedhutnar to Vwsection F <br /> z3f6e Sampling Company Log Code Analysis Request <br /> es- <br /> Phone No FAX No Global ID m x <br /> 0 W o N W <br /> Q co <br /> co CNC4 <br /> Protect Number PO No EDF Deliverable To(Email Address) m m m o y+ <br /> Q W N <br /> N ♦— F N °O O <br /> Pro ct Name// Sampler Signature 00o (a <br /> 04 <br /> Project Address — a. a J N `9 <br /> Sampling Container Preservative Matrix i, o � F N a l{p� L A <br /> � J l// f N a. ❑ y C C G G <br /> lf�Pv w W W J m `�x W m 0 F F T o' N C"oo d v N <br /> p U Z W ¢ W W 2 T S �c x 0 m Q b t <br /> Sample Desi nation Date Time v -J �1 5 v z OQrl CO m a t ° ° 1n -J f <br /> iL X1 1 �i �01 <br /> I <br /> Relin Date Time Received by Remarks <br /> A n <br /> D4, Time Received by <br /> Relinquished by Date Time Receiv y Laboratort Bill to <br /> �7r3as J 30/ <br /> Distnbution White-Lab Yellow-File,Pink-Onginator Formslcoc 121001 th9 <br />