Laserfiche WebLink
_....�•..... __._ .- .r..ry v r.-r�•-,••• -•�,r C"�"-.�,',�'e9" TK^w" _^&-W aS*- r"�a;_° mat wx �'[n "'y-^ -- - ^- 4.+.. <br /> 2795 2nd Street, Suite 300 <br /> .�� Davis,CA 95616 <br /> Lab 530 297 4800 <br /> ANALYTICAL eec Fax 530 297 4808 Lab No Page of <br /> Contact(Hardcopy or PDF To) California EDF Report? �7 Yes ❑No <br /> Chain-of-Custody Record and Analysis Request <br /> Recommended but not to cwm ete this section <br /> Company/Address Gs �,� (Tr" � <br /> S mpltng Company Log Cotte _ Q <br /> f �/,C �� uurlr �`i ( Analysis Request <br /> Phone No FAX No Global ID _ o X <br /> 0 04 w <br /> CV C4 <br /> Project Number PO No EDF Deliverable To(Email Address) wC* com o 7' <br /> m W N X YC <br /> / 000 <br /> N m a 3 <br /> Project Name ' Sampler Signatur LO b w co ro CO °6 WL <br /> r" °° m U C7 mo m ¢ m a <br /> J��.4��s/I�.G. i !i/�. �7�7✓ �/ cep y T S 04 <br /> V J N <br /> Project Address Sampling mg ContainerXPreservative Matrix , N �V CO <br /> Ea U C <br /> a <br /> C7 h $ f- m m m o c`s O <br /> f I L Q {y� N d 0 m C c > N t U. <br /> tL' m 61 N 41 U N V N <br /> �f �� r✓ /�I(/r✓ �Ch� Fv > W 0 Z f =r x m C7 m % a e0 m L <br /> C) U z lu O Q O F F 0. a a 0 O d O m �a o af9i r <br /> Sample Designation Date Time v rn = z z m m r r~ <br /> LO <br /> TF <br /> ItI I I <br /> Relinquished by Dale Time Received by Remarks <br /> J' <br /> Relinquished b / Date Time Received by <br /> Relinquished by Date Time Received by Laboratory Bill to <br /> prstrrbutrorr White-Lab Pink-Orrgrrrator <br /> f f Formslcoc 121001 fh9 <br />