Laserfiche WebLink
9 ;o 9 DID1E? !Received by: 'Relinquished by: 'Received by: Relinquished by: Received by: Relinquished by: A _ _ Signature . <br />_ y <br />- <br />c, i-4ir,,,;.:......, <br />. <br />„ 4 <br />• <br />.• <br />, <br />• <br />ii-i-ii• . i- <br />„ <br />- <br />, Is Lab ID# l(Sampler Prin liSampler Signature: 11Report Attention: la_ c 6" 1.—X- 11Project# / PO# / Global ID: IA) iiv1 EZ. g..P phone / Email: R2 SV P (2e Co ral liCity/State/ZIP: 11-4/6pL, liAddress: it a6 cyi tii(11-01 5 6 44-0 6: ICustomer: y Ge1 t <br />I <br />1 \S <br />, <br />, <br />N) SAMPLE ID -..... <br />I•) t <br />IN•1 <br />— <br />N t <br />_e_ DATE --'t <br />C,' <br />LI.) <br />0 TIME .-....., <br />rf) <br />k <br />0 <br />P\ <br />T-- - Printed Name , <br />N <br />1\3 <br />tz. <br />\ DESCRIPTION/LOCATION <br />....0 73 <br />SAMPLE TYPE <br />composite(c) discrete/grab(d) <br />..... <br />s•..„ <br />Iv <br />q, <br />Iv Date \J\ SAMPLE MATRIX <br />soil(s) liquid(I) vapor(v) other (o) <br />BTEX/MTBE/TPH-GAS 8021/8015 REQUESTED ANALYSES 7,"....,. <br />—I <br />5 <br />TPH-DIESEL / MOTOR OIL - 8015B <br />TRPH 418.1M / SM5520C & F <br />N <br />.f , <br />• Company Narne Oxy's / EDB / DCA by 8260 <br />8260 Volatiles- full list <br />--/X PCBs - 8082 <br />Electronic Deliverables (EDF) Turn Around Time: 24 Hour 48 Hour I 3 Day 5 Day (Normal) Special:_ _ NUMBER OF CONTAINERS I Total number of containers submitted to the laboratory OBSERVATIONS/REMARKS Il Notes: Method of of Shipment: