Laserfiche WebLink
M • i <br /> 2795 2nd Street,Suite 300 <br /> I(tJT <br /> Davis,CA 95616 <br /> Lab 530 297 4800 <br /> TICAL eec Fax 530 297 4808 Lab No /4 Page—Zof <br /> Project Contact(Hardcopy or PDP To) California EDF ReportsVr Yes 0 N° <br /> I'D / <br /> Chain-off-Custody Record and Analysis Request <br /> �l <br /> Come x/Address PAominw-dodbtAnot to a is � <br /> /_-" Sampling Company Log Code . Analysis Request � <br /> G6J /= <br /> Phone Na FAX Na Global ID m C <br /> 0 <br /> 0 0 W <br /> Project Number' P O No EDF Deliverable To(Email Address 2 -Nm- `✓ m o : <br /> �65. OCO <br /> W N V C <br /> Y <br /> N <br /> Pro ect Name Sampl Sign re a '" ° a m <br /> C3 W <br /> m �, to G a in <br /> W ill �y to m <br /> 7 , '" c <br /> PrLiAddress - SATIlng Container Preservative Matrix b <br /> 0 5 r m m o v o N `o <br /> 0p 16 N r UL <br /> /� m F m ci �P S O <br /> G/ L. f'T- W n W W fl m O1 m ° h m <br /> E W O z F- <br /> M le Designation Date Time v N i = v z vOi m W r r m O^ w a <br /> tf a ,lZ r <br /> Z <br /> Relinquished by D to Time Received by Remarks <br /> i t <br /> Relinquish by pate Time Received by <br /> Reltngu Elate Time Received by Laboratory Bill 10 <br /> Distnbubon White-Lab Amk Onginator Formslcoc 121001 M <br />