Laserfiche WebLink
`krrERNATIONAL ANALYSIS P WEST AND Reference Document ] <br /> 'IMOLOGY <br /> %_01MRAMON CHAIN OF COSI&JOY RECORD* Page 1 of <br /> Project Name/No 1 D-a3 R Samples Shipment Date 7 �2)2121 8,11 to 5 r,--E__Ar� <br /> Sample Team Members 2 Lab Destination o f to 14 - -J,10 A) &14� <br /> 791 <br /> Profit Center No 3 t5 f4�<i Lab Contact —�— � <br /> Project Manager4 tLprlJjokdo Project Contact/Phone 12 Report ,� c <br /> Purchase Order No B b�3 l Camer/Waybill No 13 _ <br /> Required Report Date 1 <br /> Sample 14 Semple 15 Dots/Timm 16 Container) 8amplal Pre- 19 Requested TestAng 20 Condition on 21 Dispoaal 22 <br /> Number Dee ng Collsatsd Volume servsthm ram ReceiptRecord No <br /> r 4, � N s o x <br /> 1-UH ts <br /> U LT <br /> I <br /> =F <br /> -Special Instructions- 23 <br /> Possible HRIard Identification: 24 Sample Disposal: 25 <br /> Nan-hazard Flammable Q11 Skin Irritant (JI Polson 13 ❑ Unknown Return to ClientDisposal by Laba Archive__ (mos ) <br /> Turnaro nd Time Required 26 Q�Level•27 <br /> NormaERushl.1 !— II lJl III U Project Specific s eco )- <br /> 1 Relinquished b �} � 4ate1me <br /> ate 1 Received by ( I Date 6011W <br /> 1 <br /> (signature/Affiliation) I/�L (SWwW'./Aff atlnnl Time tt�2 Relinquished y 2 Received by Date <br /> I&gnawm/Affpatron) Time. (SWMim/Affiletioni <br /> Time. <br /> 3 Relinquished by Date: 3. Received by Date: <br /> 5gneu"/Affil W=I Time. I i +) <br /> Time. <br /> Comments.29 <br /> -low 'Now <br /> urs v+sA <br /> ' � ger il■■S � �f � � 1� � � � � � � � <br />