Laserfiche WebLink
1 <br /> 1 € <br /> r� <br /> GRAIN OF CUSTODY f LABORATORY ANALYSIS REQUEST FORM IfLf I ' <br /> SHAW Environmental& Infrastructure,Inc. Purchase Order #3648 1 <br /> 1326 North Market Boulevard Sacramento,CA 95834 <br /> op L, ,5 ����� <br /> ' Lab STL 1-2—unaterm W.Sada <br /> Project Name Don Rodgers Anal sis ReQuested <br /> GloballD- T0607700717 I ; <br /> Project Number 8800391A f 01010'040 � 1 <br /> Project Manager Dart Wynne � r, <br /> Company SHAW Environmental& Infrastructure,Inc. <br /> Address 1326 North Market Boulevard <br /> I Sacramento,CA 95934 <br /> Dir Ph 916-M"184 1 FAX 916-565 6 p :9 <br /> 90 Samplees Signature REMARKS <br /> Sample LAB Sampte I konulncrTy cs <br /> 1.13 Date Time I D Matrix HC) Pt teywtttrans ; <br /> M W-I R 11--7 fit` water 3 3 i i1 <br /> MVV-2R ` � water 3 3 <br /> I� <br /> MW-3R �"1 water 3 3 1 <br /> M W-4RS water 3 3 { <br /> MW4RD water 3 3 I <br /> V W-l D 04 water 3 3 ' <br /> VW-2D lu lL- 7 water 3 3 <br /> VW-3D ?' water 3 3 <br /> VW-4 wafer 3 3 F 3 <br /> I <br /> RELINQUISHED 13Y RECEIVER BY RELINQUISHED 8t TURNAROUND y REPORT REQUIREMENTS <br /> REQUIREMENTS X i Routine Report <br /> StgrsatNJ L"11 �S*_Si" Signature Si 0= � 53mdetdl-[0.124 hr 5 wuckuR d f 11 Report�required ma be 1 <br /> Pant arae Printed IV Pri Name Printed Name Providtvaw Prchrrunwv Ramlw charged as samples) <br /> Q %�z V4, 'r �]` t ,GLI_ r 'r rmrldtFAAPsrh*mw)RmIls I11 DdLa Validation Report <br /> Firm Firm Pum Firm r actpnuaRcFanom {includes All Raw dial <br /> A �5T IL- 7 RNJQCB <br /> I3;t"'r' S1-7-a CsaielT'Me tillO f DatoTrme 10 oJ6 C,0 JE)-t,,TtmC 2 fMDLs'PQLsrFRACE#) I <br /> ' RE 1NQU15I#8 BY RECEIVED ON Special Instruclions1commenls Container Types Key <br /> i` 40 ml VOA t <br /> SagnatitrcSignature- STI,I Quanterra 125 m3 LPE 2 ' <br /> Need EDDs for CeoTracker. 880 Riversrdc Park-*av SOO ml 1 PC 3 E <br /> Printed Namc PrintO Name Send directly to. Esusan.watermall(a)shawgrp.com> w Sacra,Calif 435414 1 Mer HDPE 4 1' <br /> 415-373-96001 Fx 372-1059 Sall int 81usr 5 € 1 <br /> Firm Contact Pra+rant Prllay 1 liter glass 6 <br /> [ 20 eds ring 7 <br /> t7atwTrrne DaWTIme y E IdCoard Slier 416-565-1327 I glassOr 8 <br /> t (j i t 1 <br /> ' Page 16 of 17 , <br />