Laserfiche WebLink
r,ANWALM M 5116AIMI'Q T M wReMWncAocL�ntI <br /> c�� CHAIN OF CUSTO" ECORD` Page 1 of <br /> J <br /> Project Name/No 1 a-a /9 Samples Shipment Date 7 S 2 j 0 Bill to er – --- <br /> Sample Team Members 2 � Lab Destination 8 �P 0 —_���1 _ -*0 <br /> Profit Center No 3 50,0- Lab Contact stn " <br /> Project Manager,4 r� t �__ o Protect Contact/Phone Report to 10 <br /> Purchase Order Nos 6 i e5� Camer/Waybill No. i3 co <br /> - 3 <br /> Required Report Date - <br /> N <br /> Semple 14 SwmQte 15 Dsta/Ttmai6 Contemeeti Sampiel Pry 19 Requested Taetang 20 Coadrtaan on 21 D�epesel 22 <br /> Number Description Collected T Volume sewath" rem ReceiptRecord No <br /> � l- �� z o, � � N <br /> SID <br /> 121 <br /> � <br /> uzxc LT <br /> mr n <br /> %avow low Im VEN or <br /> m <br /> n <br /> 0 <br /> Speciallnstructions 2a 9 <br /> Possible H and Identification 24 Sample Disposal 25 ' <br /> Non-hazard - Flammable IJ Skin Irritant IJ Poison B fJ Unknown fJ Return to Client IJ Disposal by l ab J Archive (Mos ) m <br /> n <br /> Turnaro nd Time Required 26 O Level 27 <br /> Norma RushL J 17.j Ill FJ Project Specific (s eci ),_. — <br /> 1 Relinquished b r' - Date 1 Received by Date 60110 <br /> (5�pnewif/Affil��uon) `/ Time /1 LZ i5gnewre/Affi�iernn) !DA&, k Time tl` <br /> 4 <br /> 2 Relinquished 6y C9 Date 2 Received by Date <br /> ftnetarne/Af Batson) Time (&VwU a/Afitirennn) Time <br /> 3 Relinquished by Date 3 Received by Date — <br /> (SignetLry/Aftawnl Time. Time <br /> Comments 29 <br /> UCA�,� , <br />