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1 JAS./�•tj/�� -' b Z) <br /> �... T (t-i/�/" • E o s e c o P �'��f� <br /> CHAIN-OF-CUSTODY RECORD <br /> SAMPLER: (Signatu/r.V .L. • _ <br /> - ' Date Shipped - Carrier <br /> Phone Airbill No. <br /> Cooler No. <br /> SHIP TO: SEND RESULTS TO: <br /> Enseco-Cal Lab' Client Name . <br /> 2544 Industrial Blvd. Company <br /> West Sacramento, CA 95691 Address <br /> (916) 372-1393\ <br /> ATTENTION: Phone <br /> PROJECT NAME PROJECT NO. P.O.NO. <br /> Relinquished by:-('Signature) Received by: (Signature) Date Time <br /> Relinquished by: (Signature) Received by: (Signature) Date Time <br /> Relinquished by: (Signature) Received at lab by: (Signature) Date Time <br /> Relinquished from lab by: (Signature) Received by: (Signature) V Date Time <br /> ANALYSIS REQUEST <br /> Sample ID Sample Date/Time Sample Condition <br /> Number Description Sampled Analysis Requested Upon Receipt <br /> r' 7-- <br /> '( <br /> , - uy <br /> Special Instructions/Comments: <br /> NOTE: UNUSED PORTIONS OF NON-AOUEOUS SAMPLES WILL BERETURNED TO CLIENT <br /> Expected <br /> Analytical Immediate i <br /> T.A.T's: Attention (z00% surcharge) RUSH (so-l00% enrehar[e) Standard <br /> Cal Lab ID Number: (for lab use only) <br /> Client Retains White Copy Only (Revved 1/87) <br />