Laserfiche WebLink
RECEIVED FEB 9 MID <br /> SAMPLE CHAIN OF CUSTODY RECORD Client sr _ <br /> California Address / c '� <br /> Water Labs (please print) Phone No. ZDy <br /> 1033 Proj. MgrXontact mea <br /> P.O. Box 4249 Ship samples to: Pink -Field Copy <br /> Modesto, CA 95352 1430 Carpenter Lane White and Yellow-To Laboratory with Samples <br /> (209) 527-4050 Modesto, CA 95351 Record of Yellow- Return to Client <br /> ti <br /> v <br /> PROJECTISITE NAME: x0 ANALYSIS REOUESTED <br /> PROJECTICONTRACTIPO NO.: <br /> 1311 <br /> NAME OF SAMPLER: I., REMARKSISPECIAL INSTRUCTIONS <br /> Y � <br /> LAB USE ONLY SAMPLE am NUMBER S <br /> f ¢ OF <br /> LAB I.D. I.D. DATE TIME 0 CON- <br /> 0 0 TAINERS <br /> C1D71D Ziyl 1-ZS ivis yZ x 0 <br /> I <br /> ELI UISH BY SIGN DATE/TIME RECEIVED BY SIGN DATE/TIME RECEIVED FOR LABORATORY <br /> f Q <br /> BY(SIG +' DATE/TIME /(, 9&' <br /> RECEIV <br /> []COLD AND INTACT OTHER PRESERVATIVE EYES ❑NO <br /> ❑OTHER: <br /> TURN AROUND TIME: <br /> SHIPPED VIA: ❑FED X ❑UPS ❑OTHER: SHIPPING ORDER NO.: E124-Hr C2-Day D5-Day 014Day <br />