Laserfiche WebLink
K o 3/- z3 <br /> _ CHAIN OF CUSTODY RECORD <br /> CLIENT � CK Yincorporated <br /> NAME: R . C . L �' r REQUEST OR ANALYSIS '/ Analytical Laboratories <br /> ADDRESS: -3y -L1 T� / 4yr) # (�_) DATE: / &� --v 630 Maple Ave. <br /> Tn/-]l7�(/('13'1114 <br /> �.F C4 C/06 PAGE OF Tonance,Calif.90503 <br /> q J ` Te1:AI0-618-8889 <br /> PHONE NO.�-(JC'532'RI J 14 FAX NO.�(-537 elq ! Faz� 0-618-0818 <br /> PROJECT NAME: S' -qq-D-001D- 00#bola. . <br /> SEND REPO RT TO: J V <br /> TURN AROUND TIME ANALYSES UI D <br /> SAMPLER NAME/SIGNATURE <br /> NORMAL:`' ❑ m � <br /> �LE L i �4111:�7411' <br /> RUSH ❑ <br /> SAMPLE SAMPLING PRE R- CONTAINE SAMPLE DESCRIPTION <br /> NUMBER DATE/TIME VATIVE SIZE/TYPE WATER SOIL I OTHER e $ $ `° `° U VD C� • <br /> 916 - X ix I xxi <br /> 6 /i . qs 4/130 <br /> �0( x44= <br /> x �t <br /> --- - — <br /> COMMENTS: ----- <br /> 41-}PLE5 -DO NOT TH15 T1/776 - CO/UTi9e7- P7//CE DEKLoTL C316) �79a-37a6 <br /> T 2 C-5>1 <br /> Relin ' e b �(�'ig lure) Date:G ce b Si atu e) "Ile:ar ReAnguished by: (Signature) Date: eived by: (Signature) Date: <br /> Compa_y: Time: pan Time: Company: Time: Company: Time: <br /> I CC ( Dam <br /> Storage/Disposal of Samples: Sample will be st edatCKYfor36days at no charge and at$10/sample/month thereafter. Disposal of sample by the Laboratory will be charged at$10/sample. <br />