Laserfiche WebLink
J Appendix H <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH <br /> CHAIN OF CUSTODY RECORD <br /> 1. Sampler's Name la�[�c Title Dept. <br /> 2. <br /> Date Time Item Location ID# Unit Required Remarks <br /> Analysis Conditionlremperature <br /> /- 74'h7 <br /> 1 <br /> 3. Evidence tape <br /> 4. Sample transported in iced cooler [fes <br /> S. Relinquished by U /-2 -57 //:d3 <br /> a e title 4 date time <br /> Received by ��„g� Leis ` . /-2&-i�— . //c' 3 <br /> e title �dnteu�� <br /> sstrNj✓Ccs i ,�.� <br /> remarks (condition/temperature) <br /> 6. Relinquished by PL2, <br /> name title date time <br /> Received by CC'gTFU(- d) chZ( GE-0 I CCN• . 128— L o <br /> name title date time <br /> 5AM'���5 ZE��yiI�FG-�stiH clt5,—�Dv iA'r� nIQ 7N�M. <br /> remarks (condition/temperature) <br /> EH __ 13 <br />