Laserfiche WebLink
ALCON 1 <br /> <br />(_! <br />ASSOCIATESMERGY AF L CHAIN RECORD AND ANALYSIS REQUEST -OF-CUSTODY IN PARTNERSHIP WITH THE ENVIRONMENT <br />PROJ. NO. PROJECT NAME # CONTAINERS SAMPLE TYPE ANALYSIS TYPE REQUESTED <br />NO. <br /> <br />,\ /\:) <br /> <br />ea %, <br />h <br />' .A PRERSEEMRAVRAKTSivi ES <br />SAMPLERS: (Signature) <br />SAMPLE I.D. NO. DATE TIME COMP GRAB SAMPLE DESCRIPTION <br />& LOCATION <br />1 13Act. 144LI) I sci,- : . _ LANA / ifft, 6 <br />3 i i I cAL- <br />4- ii 1 90" &A0141 <br />A 4 <br />Relinquished by: <br />--- , .. . <br />Date <br /> <br />, -, <br /> <br />/ _ :. <br />Time <br />, / _ <br />Received by: <br /> XIT,,,, <br />Relinquished by: Date <br />,,••._ - ,:i : : <br />Time Received by: <br />Relinquished by: Date Time Received by: ( Relinquished by: Date Time Received by: <br />' Relinquished by: <br />• <br />Date Time Received by Laboratory: Date Time REMARKS (Shipping Related): <br />P.O.' BOX 1257 • STOCKTON, CA 95201 • (209) 463-7108