Laserfiche WebLink
Lq_w 90% too] <br /> DATE 14 S 915- PAGE -'2 OFCHAIN OF CUSTODY RECORD 3907 <br /> 1 Envlronniental <br /> PROJECT NAME_ [�cc�: i,.ti r ANALYSES TO BE PERFORMED MATRIX ��` ScienceADDRESS Q M U C Engineering, Inc <br /> A M N <br /> PROJECT N0, de7 ,tom T B T 4NO koll Mt l III Plione(SEo)689 441 <br /> l h R E A s ' 1 <br /> SAMPLED BY X R I c mu oid (n Q F211 r Fax(510)685 5321 <br /> '�c�� W ��,� <br /> LAB NAME �, 0 E ' <br /> F R REMARKS1536 <br /> SAMPLE # DATE TIME LOCATION MATRIX S (CONTAINER, SI7 , <br /> � <br /> 3b <br /> AL 1313 <br /> 131308 <br /> 3ab �33a r <br /> 3 �3qS <br /> 33� <br /> � a <br /> r <br /> 15 <br /> 3325' <br /> 3325' W43 ` <br /> RE bED <br /> r ' <br /> . (signature) RECEIVED BY: (signature) date time Ja TOTAL NUMBER OF'; ' <br /> 2 . REPORT SPECIAL SHIPI0 r <br /> RESULTS TO: REQUIREMENTS , r <br /> 3 . <br /> 4 . ~l Cot' S>!•cP/ i ,�! 1 / ' <br /> r <br /> 5 . W CW�ap� <br /> SAMPLE RECEIPT <br /> INSTRUCTIONS TO LABORATORY (handling, analyses,- storage, etc. ) : CHAIN OF CUSTODY SEALS <br /> REC°D GOOD CONDTN/COLD <br /> MEN �_ LLL CONFORMS TO RECORD <br /> GDQC COOL► <br /> HEAD SPACE ASSENT., CDW"AIK S2 <br />