Laserfiche WebLink
Sample Transportation Notice 189 BLUE RAVINE ROAD,SUrrE B <br /> AIRAITOXICS LTD. Relingwslting signature on tits d�Cume't ndiCM'S that Saml:le[Y being ShivPcd in ccmpliance OLSC}M,GA 95630-4719 <br /> with all applicable :aeal, Stpte, redera. natiarai, enc injerr4riorw ianvs, rertvia:iens and (018)D86-1000 FAX:(916)9136-1020 <br /> ANENviRONMENTALANALYTICAL LASMATCHY WIN of any kind.Air Taxied Limited assumes na Iiabbry wit rnspest to VIe col ectie'), <br /> handlin4t at ahvOna of these simples.Rdinquishing siW121111T also indiubes agreerner8 to hole <br /> CHAIN-OF-CUSTODY RECORD hann'ess,defend,and irdlamnify Air Toxics Unshed Pgalr,t any cairn,demand,DF action of any <br /> 16,aI1 blind,related ea ehe=Ag-.tion,handling,or shipping of sampled.D.O.T.HD&L,(8001467-492.2 Page of <br /> Contact Person OA-.NEt! AS,-X-F _ Project infer: Tum Around'Time: <br /> Company 'SA P.O. 4 ))Normal <br /> Address t60 K. 1467E-L aa,t ,City Stale+CA` Zlp2WELt Project# D Rush <br /> Phone ) A 7 X �2A 41*- �'�$ Project blame �= Specny <br /> Collected By:signarcee 4 <br /> Canister Pr'e$Sure/Vacuum <br /> Lala .. <br /> ,. . Field Sample I.D. Date&Time Analyses Requested Initial Fina[ ':,6ePfiip!t <br /> r � a lel L^ sEft ''. I -+'} <br /> rl tl+151- <br /> Wp <br /> MoS 142[3 <br /> Rab gcishad 8r y R3 ace nseRCOCivad B)r,[Mena um Milff ne Notes: <br /> P,el a i r {Sig , Date Regei;eo ;($�81uru;• Cal;r <br /> ,/I °,T Q3b <br /> P,al-iGuisred 8y.(Signatve? Oslell l� RMivw$y:, azure: a ctT•'rte <br /> .. .... .�>Y.!':,� :,...,.: . •.• •:Air$iji':�':. . f�ft8id E3�j::. <br /> .,. . .. .,.. . .. <br /> M• <br /> B ( !7, Yes No .. • ane 41f r7 <br /> F7rn 9 rev.0 <br />