Laserfiche WebLink
• 180 BLUE RAVINE ROAD*ITE B <br /> AIR TOXICS LTD. FOLSOM, CA 95630-4719 <br /> ctl (916) 985-1000 FAX (916) 985 1020 <br /> AN ENVIRONMENTAL.ANALYTICAL LABORATORY pp( <br /> 1 ON("'i <br /> CHAIN-OF-CUSTODY RECORD Page _L of <br /> Contact Person ^� a ffP/S o n <br /> Project Info Turn Around Time <br /> Company ro yj , 4 ec_al �e // PO # <br /> Address �� �� '���� �� Clt ��J"_f t" State 95R� Imo] Normal <br /> Y �. Zip Protect # r � ❑ Rush <br /> Phone �/& N -o t 3 -FAX Protect Name A� o #Z 17 3 Specify <br /> �p Pleld Sample I D Date & Time Analyses Requested Canister Pressure / Vacuum <br /> Initial Final Receipt <br /> QT Xe- <br /> FEE <br /> Collected By Print fe Notes <br /> ai i lv A�aL dP <br /> Relinoulshed y alum} DaterriReceived By ( gnature) Daterrime <br /> 1- 11 9t' <br /> foo <br /> Relinquished B 1 <br /> (Signature) Daterrme eived By (Signature) Dalw7ime <br /> Relinquished By (Signature) D e R dBy (Signat a p a .e <br /> } j r <br /> 1w <br /> Shipper Name Alf Bill# opened By Datefrime Tem (°C) Condition Custody Seals Intac Work Order!t <br /> use <br /> v`� r t���( NN ►�1� t 1t I <br /> USE Yes No <br /> Only 1 5-- <br /> .rr r <br /> Foran 1293 ruv 05 <br /> r <br />