Laserfiche WebLink
dftT!i EMERY COMPANY CHAIN OF CUSTODY <br /> nli 5enrce Independent Testing Laboratory Ertabhshed 1904 ANALYSIS REOUE <br /> 7 I East Washington Boulevard • Las Angeles Cahfomra 90021 • (213)749 3411 • Fac (213)745 6372 DATE `3 PAGE OF 3 <br /> PO Box 880550,Hurler's Point Shipyard Bldg 114 • San Francisco,California 94188 • (415)330 3000 • Fax (415)922 5864 � �� <br /> 5427 East I a Palma Avenue • Anaheim California 92807 • (714)693 1026 • Fax (714)693 1034 FILE NO __!y Y6lLAB NO 64 1 <br /> CLIENT NAME r ANALYSES REQUESTED. REMARKS <br /> PROJECT NAME � Vl PROJECT NO -r PO NO <br /> ADDRESS 1701kledumizWhy, <br /> PROJECT MANAGER PHONE � 32 _O ,z FAX# 3Z_1/ZC13 7- <br /> `SG{ <br /> SAMPLER NAME UJI �• <br /> / [sonahire) <br /> TAT{Analytical Tum Around Time) 0-Same Day, i -24 Hour, 2-48 Hour, (Elc) ¢ m <br /> � N <br /> CONTAINER TYPES B=Brass,G-Glass,P-Plasfic,V e Voa Vial,0-Other � <br /> SAMPLE DATE TIME MATRIX CONTAINER 00 � <br /> SAMPLE CONDITION/ <br /> NO SAMPLED SAMPLED SAMPLE DESCRIPTIONwCOMMENTS <br /> ri�it son. noes arrtoi TAT e � <br /> 46A ,Z:05* <br /> I i ideY _ and Printed N Received Sy-(Sipneturs and Pnnied Name) Data rima <br /> SAMPLE DISPOSITION <br /> Relirpuished nature and Ponied arae) ,,, S 1 Samples returned to client? YES <br /> ipnaerte end Pri Name) �LL Time <br /> d Ie9 p 6 2 Samples will not be stored over 30 days unless <br /> additional storage time is requested <br /> Reh By-(Signature and Printed Name) Aeceived By ISigaature and Printed NaZo Dale Time <br /> 3 Storage time requested days <br /> SPECIAL INSTRUCTIONS <br /> 1By Date <br /> DISTRIBUTION WHITE,YELLOW, PINK TO SECO—GOLD TO CLIENT <br />