Laserfiche WebLink
T <br /> CHAIN OF CUSTODY RECORD <br /> SAMPLER (sig nature) / <br /> � l �,�=��� Applied GeoSystems <br /> Q <br /> Phone 4191-E Power Inn Road,Sacramento, CA 95826 (916)452-2901 <br /> �' S u y� —) ���� <br /> • Fremont •Costa Mesa •Sacramento <br /> LABORATORY' SHIPPING INFORMATION . <br /> Shipper .� <br /> Address <br /> Date Shipped <br /> TURNAROUND TIME —T-6jo Service Used <br /> Attention E ,fit .tis Atrbill No <br /> Cooler Na <br /> Phone N0/2 -- <br /> Relinquished by (771� <br /> =-'26 <br /> ) Received by (signatures) Date Time <br /> Received fo laboratory b <br /> LABORATORY SHOULD SIGN UPON RECEIPT AND RETURN A COPY OF THIS FORM WITH THE <br /> LABORATORY RESULTS <br /> Sample Site Date Analyses Sample Condition <br /> No Identification Sampled Requested Upon Receipt <br /> t' <br /> 1 <br />