Laserfiche WebLink
FGL ENVIRONMENTAL CHAIN-OF-CUSTODY RECORDB PROJECT <br /> (See Reverse for instructions) NO,:� (0 )1 <br /> PROJECT I�AAdE �r '£ gYOS SAMPLERS �"' � � SAMPLE CONTAINER SAMPLE DESCRIPTION CODES TAT CODES <br /> E t t, �lv <br /> FT I �t J DESCRIPTION CODES A Gmun6 M161 F CIO � <br /> K dbrnl VOA Vial a Sbdue W"f 6 =50m- <br /> PROJECT <br /> NUMBf ia Grass Lnes E BrassTrt,e c tes hate H Baati�S/ C PNeft 5W"J F O1htr D Ringeatc L 000 rx <br /> I� <br /> RECORDER (SIGN) - D Plaoc Us( E SO4Gesanen+ s Gxet <br /> OD <br /> r, rtuMaEA of ANALYSIS fiEQt1ESTED <br /> LABORATORY USE ONLY <br /> co AINERS u <br /> C- ANDUD <br /> 8 18 P SEs iloN n x �$ ay SAMPLE <br /> NOTES <br /> ASSIGNED UPON <br /> DATE TIME SAMPLE ID a z NUMBERS RECEIPT NOTES <br /> r 0 1 - <br /> k mo Ar 7 - ZD " I 2 Saw <br /> 4 1 _ Z Z Ki <br /> 0 <br /> r %I <br /> r: <br /> J <br /> Cr <br /> H <br /> z <br /> w <br /> E <br /> Z <br /> 0 <br /> W <br /> w NOTES lMISOELLAHEOUS / IH t'p'!R Ivor, � <br /> e) By' ) Tlrne <br /> GLZ fSlm�� PaceS'f� �f��a� ' <br /> y RPBy (SE ore} wed By (Sl9 aiure) Ttrn9 <br /> 1 3shed ST.{Signature) RsoeW d Or{fie) Date Tetra <br /> IL M of sho t ] v ton of Other Cl urrOF-Custody 1? Sed Br-(81"Ure) Date Tam Reeewed for lob Br POWlTor <br /> urei Dide re <br /> Tr �Omerrarrt Sertal�lb NO) <br /> m <br /> Q <br /> Send Lab Rest,lts to(Name} #' SSA' 2 0 h" Y S/tG (Check Office Below) Verba4s ReWas�_ Yes D No ❑ <br /> °' ❑ $71 CKTON �Z ❑VISALIA <br /> SANTA PAULA � _ <br /> I �; EL(2092 942-0181 TEL(209) 734-9473 <br /> TEL (805) 659-0'910 <br /> z FAX (805)5254172 tAX (209)942-0423 SAX (209)?38-6273 <br /> i L <br /> SGL HNVlRONmprrAL LARORATORY •200 STAGEMACH ROAD • STOCKTON,CA 45215 •TEL(W 942-0181 • FAX (209)942 <br /> UWTE_Fad6CV) YELLOW PAWnCo" RECEIVED J U N v z) I9�j <br /> r <br />