Laserfiche WebLink
CANONIE ENVIRONMENTAL CHAIN-OF-CUSTODY RECORD No� <br /> (See Reverse for Instructions) TAT CODES. <br /> Olr� SAMPLERS Wtt�r�"'" SAMP E CONTAINEf1 SAMPLE DESCRIPTION CODES <br /> IN\A DES IPTION CODES- A. Gmpndwaler P. t. standard <br /> PROJECT NAME - e. Sudan Wabr G. wale ; <br /> _ A. OA Vial C. Leachate H. elanklSPlke 2. M Hour <br /> // k (SIGN) 9. Glace liar E. arm Tube Dow 2. of Haut <br /> PROJECT NUMBER��— {(� _ D. nlowate h <br /> W�'rr C. %uryc See.ml F.011ier E. SOIUSedlment !'p �T <br /> ' rt{An�.�� . p�Plulk.Lller. ' <br /> RECORDER <br /> (91GN) LABORATORY USE ONLY <br /> - NUM13ER OF <br /> ANALYSIS REQUESTED <br /> - CONTAINERS - u AND ° SAMPLE <br /> E1 <br /> PRESEFNATION� §}- 6 _ NOTES ASSIGNED CONDITION <br /> _ BOTTLE UPON <br /> NUMBERS RECEIPT NOTES <br /> i <br /> DA E TIME SAMPLE ID. k <br /> K 1C <br /> r <br /> aTit <br /> 4 <br /> ,f <br /> Ish ( ) .R pe Byj(�I tui) // �d ete� OC <br /> - y SI eWre � <br /> NOTES I MISCELLANEOUS - Rec I d By: (Signature) to /ai <br /> l VIlnq �:1$Ignature) .,._ '( / <br /> 'GReceived By: (Signature) Date Thelinquished By: (Signature) <br /> Ti <br /> Date Time Received for I y:(Signature) Date <br /> Method of Shipment Description of Other Chains-Of•Custody Dispatched By: (Signature) <br /> Transport Container, notiedCith this <br /> halnp(by Serial No.) <br /> 2R X. (Check Otfice Below) Ver s, Requested: Yes No <br /> Send Lab Results to (Name): . - ❑ PORTER �'Q�HERI�I _ <br /> ` ❑ IRVINE ❑ MT.VIEW TEL(219)926-8651 TEL <br /> TEL <br /> ❑ ATLANTA ❑ DENVER TEL(714)757.1755 % TEL(415)960.1640 FAX(219)926-7169 1 FAX <br /> ` TEL(404) 951.0055 TEL(303)790.1747 FAX(714)757-0960 FAX(415)960-0739 OTHER <br /> w:p•: FAX(404)956-9364 FAX(303)799-0188 ❑ PLEASANTON ❑ PORTLAND TEL <br /> ❑ HOUSTON ❑ KING OF PRUSSIA TEL(510)463-9117 TEL(503)241- f1l FAX <br /> 1 l 1❑ BOZEMAN TEL 215)337-2551 FAX(510)432991 FAX(603)241-0408 <br /> TEL 713 556+1688 <br /> T-,ll TEL(406) Sfi69496 GeV�� �� AMMAp FAX(215)X37-0580 ., ___ __ ,., _ . — ceta(1NF f3031 290-8336 • FAX 303 29( <br />