Laserfiche WebLink
of'' <br /> ge <br /> Chain of [ustodeCo)rd e iJ � Oa-site Time ��d Temp � <br /> ' I <br /> Protect Name _ Oft-site Time&Z-0 Temp <br /> BP BU/GEM CO Portfolio: <br /> �� ( Slry Conditions <br /> BP Laboi atony Conti;act Nuinber: Rnd <br /> teorological Events Q~ <br /> ) <br /> Date- g '{�G Requested Due Date(mm/dd/yyfir-- Speed Direction <br /> Send To: BF/GEM Facility No Z l G Y Arc d Consultant/Contractor ..00✓• <br /> Lab Name BP/GEM Facility Address [��Vr �(p.,! Address O <br /> Lab Address �, W ( Site 1D No A- <br /> 7 Site Lat/Long -mail EDD <br /> «Wt California Global ID# T e Consultant/Contractor Project No 2 lG Ir <br /> Lab PM BP/GEM PM Contact Consultant/Contractor Tele/Fax 5-10—C.76 6d+e$ <br /> Tele/Fa p Address Consultant/Contractor PM ) <br /> Report Type!QC Level l Invoice to Consultant/Contractor or w2mp (Circle one) <br /> BP/GEM Account No Tele/Fax BP/GEM Work Release No <br /> Lab Bottle Order No Matrix Preservatives Requested Analysis <br /> Item <br /> Sample Description Time Laboratory VaC N x Sample Point Lat/Long and <br /> oNa <br /> A <br /> v 4. M °O N N Comments <br /> v1 o O d d <br /> O zz <br /> 2 �`'��✓ • k y r 7C <br /> 4 <br /> 5 <br /> 6 <br /> C OL R ST)D`+j SE LS i NTIfT Lj <br /> 7 <br /> ®1 JN C <br /> TTIIV CO$ °c <br /> 9 <br /> ]0 <br /> Sampler's Namem Kt, Rebngwshed By/AfrWation Date Time Accepted By!Af1`ilra n Date ane <br /> Sampler's Company <br /> Shipment Date <br /> Shipment Method _ t p ��� � r� <br /> Shipment Tracking No r <br /> Special,Instructions <br /> Custody Seals In Place Yes .- No Temperature Blank Yes No '-" Cooler Temperature on Receipt °F/C Trip Blank Ycs No <br /> LABORATORY BP COC Rev 1 215142 <br />