Laserfiche WebLink
Anlab Client Code: CHAIN OF CUSTODY RECORD". � Page of <br /> CLIENT INFORMATION <br /> Company: Contact Name: ��.� �//�,�; A..f Anlab Use Only: <br /> Address: 333 /a s �P/ O Hours: <br /> ANALYTICAL LABORATORY city: S State: zipy.S�1 Miles: <br /> �' Billing Address: "*1 Equip.: <br /> 1910 "S" STREET • SACRAMENTO, CA 95814 Telephone: <br /> :r1f-14 —a.AS/ FAX: 3(eoz —rJ9/� <br /> (916) 447-2946 • FAX (916) 447-8321 <br /> P.O. Number: 47-9.l,JS`/O.O(7 Project Name:IC'A��FHr✓l <br /> Sampler's Sampler's Co.: k <br /> } Sample Type Number of Containers Preservation <br /> ANALYSIS IL w w s s P G VS - T A B <br /> y W 0 L L L 0 T E C A <br /> IUAAAE 91 <br /> B <br /> L D S S R P D E <br /> SAMPLE IDENTIFICATION Date Time C 1 E 1 E L <br /> l X11 V C E <br /> X <br /> U15 X x x x X X l y <br /> r�� S 7 90 f <br /> t <br /> COMMENTS/SPECIAL INSTRUCTIONS: <br /> 1 A� TURNAROUND TIME: SAMPLE DISPOSAL ❑ HOLD <br /> \-.''1 LI RETURN ❑ DISPOSE <br /> 24 HOUR I 48 HOUR 1 72 HOUR <br /> SHIPPED VIA: <br /> / 5 DAY❑ STANDARDf_ Lj UPS ❑ FED-EX ❑BUS <br /> SAMPLE RELINQUISHED BY PRINT NAME/COMPANY /D'ATE/TIME R C IVED BY PRINT NAMEICOMPANY <br /> (N ll a h <br /> r <br /> a <br /> ANLAB WILL PERFORM THE SERVICES IN ACCORDANCE WITH THE NORMAL STANDARD OF WORKMANSHIP IN THE PROFESSION.THE TOTAL LIABILITY OF ANUS.ITS OFFICERS,AGENTS,EMPLOYEES OR SUCCESSORS,TO THE CLIENT,SHALL NOT EXCEED THE INVOICED AMOUNT FOR SAID <br /> SERVICES.CLIENTS'ACCEPTANCE OF A WORK ORDER AND/OR PROPOSAL RELEASES ANIAB FROM ANY LIABILITY IN EXCESS OF THE INVOICED AMOUNT FOR THE SERVICES,NOTWITHSTANDING ANY PROVISION TO THE CONTRARY IN ANY CLIENT PURCHASE ORDER OR CONTRACT. <br /> All hazardous waste samples will be returned to Client or billed for disposal. <br />