Laserfiche WebLink
AIN OF CUSTODY RECOR® BdITa CAL�� Qr�� L r N 7ff-- <br /> Sherwood $071 N Lander Avenue <br /> PO Box 937 <br /> Hilmar, California 95324 <br /> Labs (209) 667-5258 Attention Phone <br /> C 0 R P O R A T 1 0 N FAX (209) 667-2581 C�sit�r.� S z-7_!z4 7 Page _ hof <br /> Job Number PO # Protect Name <br /> :11— <br /> SampWrs (Signal e) Site Address <br /> 7111 t <!t11a,,?-7-Q? zt�q5 i c(C ice] ���' �o`t' qry°� �° mrd <br /> NUMBER TYPE Q - 4y O� <br /> SAMPLE LOCATION DATE TIME SAMPLE �, �i .Z <br /> (IDENTIFICATION) (MTHIDAYNR) (HOURIMIN) OF {GRAB MATRIX Q� <br /> CONTAINERS COMPOSITE) � �` � � REMARKS <br /> x`E'p,, �/ �i7.a-3 Gc�ic,� '� ✓ ✓ <br /> _ Ll V <br /> sr <br /> �G�m t,a -- f! L 5 14rn d ✓ ✓ <br /> 3 Z z' ,,, ✓ ✓ ✓ <br /> L�Lc�rr-z L� � Z��-ter•-, ✓ ✓ <br /> GIS rri tc� Y � � `r✓ ,;,., .� .i <br /> Relinquished By (Signature) Date/Time Recerved By (Signature) Date/Time <br /> TURNAROUNDTIME <br /> Relinquished By (Signature) I DatefTime 14M d By (Signature) U Daleftime 24 HOUR ❑ <br /> !, '�� �� f>� n���ai ,SoPI� �l 6-1 48 HOUR ❑ <br /> Rt;knqucshed By (Signature) Date/Time Received By (Signature) Date/Time 5 DAY QM <br /> DISTRIBUTION Original Accompanies Shipment Canary Copy Sherwood Pink Copy Sampler NOTE Samples are discarded 30 days after results are reported unless other arrangements are made <br />