Laserfiche WebLink
----- <br /> CANONIE ENVIRONMENTAL �--- iA1WOF-C ST DY RECORD AB PROJECT. <br /> (See Reverse for Instructions) No. Z�` � <br /> PROJECT NAME T r Lp t+ �} SAMPLERS 1e SAMPLE CONTAINER SAMPLE DESCRIPTION CODES TAT CODES <br /> (PRI DESCRIPTION CODES A. Ground Water F. Oil <br /> PROJECT NUMBER A. 40-ml VOA vial 8. Surface Water G. Waste 1. Standard <br /> (SIGN) W Glass Liter E. Brass Tube C. Leachate H. alanklSpike 2. 48 Hour <br /> C. Plastic 5Mml F.Other D. Rinseale I. Other 3, 24 Hour <br /> RECORDER (SIGN) 0. Plastic Liter E. Soii/Sediment 4. Other <br /> NUMBER OF ANALYSIS REQUESTED LABORATORY USE ONLY <br /> CONTAINERS SSptt <br /> AND $- <br /> PRESERVATION A a <br /> ^ _ J SAMPLE tax � NOTES SAMPLE <br /> ASSIGNED CONDITION <br /> 1111P - BOTTLE UPON <br /> Ar <br /> DATE TIME SAMPLE-ID I NUMBERS RECEIPT NOTES <br /> f ,20 <br /> 7d`r ns <br /> 101-11 idh <br /> "`u(Signature) Date <br /> NOTES!MISCELLANEOUS �� ` Relin fished (Signature) eiv By' TIme <br /> OL 4 <br /> Relinquished By: (Signature) ecoived By: Time <br /> Relinquished By: (Signature) Received By: (Signature) Date Tim, <br /> Method of Shipment Description of Other Chains-Of-Custody Dispatched By: (Signature) Date Time Raceod for lab By: (Signature} Do a Ti <br /> Transport Container Transported With this <br /> el Avs� >} Chain(by Serial No.) <br /> -� <br /> Send Lab Results to (Name): tug (Check Mica Below) Verbals Requested: Yes ❑ No ❑ <br /> ® PORTER ❑ SAN MtATEO � IRVINE D ORLANDO ❑ OTHER <br /> TEL(219)926-8651 TEL(415)573-W12 TEL(714)757-1755 TEL(407) 7428 TEL <br /> FAX(219)928-7189 FAX(415)573 FAX(714)757 FAX(407) 855-2595 FAX <br /> ❑ DENVER ❑ KING OF PRUSSIA ❑ HOUSTON ❑ MT.VIEW ❑ OTHER <br /> TEL(303)790-1747 TEL(215)337-2551 TEL(713)558-1888 TEL(415) 1640 TEL <br /> FAX(303)79"186 FAX(215)337-05W FAX(713)55 FAX(415)960-0739 FAX <br /> CANONIE ENVIRONMENTAL LABORATORY a 212 FRANK WEST CIRCLE, SUITE A a STOCK'TON, CA 95206 a TEL. 209 983-1340 a FAX 209 98U304 <br /> Iq 011t^-7 WHITE:Field Copy YELLOW:Project Copy PINK:Laboratory Copy <br />