Laserfiche WebLink
ASSOCIA TED LABORA TORIES <br /> Bate III Page o <br /> LAk 506 North Batavia-Orange, California 92568 <br /> Pleura.(714) 771-6900*F= (714).535--1209 <br /> CHAIN OF CUSTODYRECORD Assigned <br /> PROJECT IDENTIFICATION/LOCATION: SAMPLE TURNAROUND T <br /> CI IHNZ: ktn <br /> t <br /> Requested Turnaround Time(CIRCLE ONE)* <br /> AI? REQS `� Priority Charges Apply to Rush Turn Asea T s <br /> PURCHASE ORDER#: RUSH: same Day 24 Hr 48 Hr 72 Hr <br /> STANDARD: Standard TAT**(5 to 10 Working Days) <br /> ° °" C Other <br /> Is this the addreskthe fttnal report is to be sent to`? Yes_No SAMPLER:(PrintAND Sign) *Availability of Same Day/24/48/72 Hr TAT Varies Based Upon <br /> If"Nay"list availing address in"Special Instructions"section at the Test Method Requirements, <br /> bottom of anis Chain of Custody. **Standard TAT Varies According to Analyses. <br /> ---------- <br /> SAMPLE CONDITION rNFO-FOR LAB USE ONLY., <br /> NTACT PERSON: <br /> — _ .: .. �': PHONE#: l g samples Intact: Yes No <br /> SAMPLED BY(Circle One): Client Assoc.Lala Per•soanrnelSample Seals Intact: Yes No N/A_.— _ <br /> PAX#: t1 ) _Cooler Seals Intact: Yes No_ N/A <br /> Sample ID Sample or Location Description Date Time Matrix(See #of Codes Below) ContainersPreservatives Test Required <br /> " &i tri l l° �C , <br /> �. <br /> .. it <br /> r <br /> MATRIX. GW=Ground Water DW= rinking Water WW=Waste Water SW=StoJ S=Solid/Soil A=Air L=Liquid I+=food (Use the codes shown hereto identify the matrix aboly) <br /> Relinquished by:(Print AN Sign}Rea Received F3 :(Print A-1t)Si t t)ate,Time:} �SeL'na� Y13trl}CtiOns: <br /> t 1361) <br /> Relinquished by:(Print AND Sign}*e° � t a' Recti (Pript D St } DatelTimo: <br /> - ' <br /> Relinquished by:(Print A Reeeivcd by Lab for Analysis: I)aterFime: / , <br /> (Print AND Sigoll <br /> ***By signing this Chain of Custody you COC:DISTR[BUTION: <br /> are authorizing the analyses shown above. (Print 'i Sign} <br /> White with report. Yellow to AI. Pink to Client's Courier. <br />