Laserfiche WebLink
Performance Analytical Inc. 20954 Osborne5lroet <br /> y Canoga Park,California 91304 Chain of Custody Record <br /> EnvtronroentalTestingandConsulting Phone 8 IS 709-1139 fax 518 709 2915 Analytical Services Request <br /> Client/Project Name Address/Phone PAI Pro)ect No <br /> I 1y3 3 iv&i itt lr)'iatlrLTfit�f_-�' ANALYSES <br /> EngcoI Y AcA,netirro,c.a 7Xr7pl9 <br /> t _,ON -34' � ��1-ILja <br /> Pro)ect Location Client Protect No <br /> -TEtCH EST— s rUCl- }-TVN �`1 u G C�L/ <br /> Contact Sampler(Signature) PO No <br /> M,4-r r <br /> Sample Lab Type Expected <br /> Identification No Date Time Sample No of Sample Turnaround Remarks <br /> r Time <br /> 3c> �S 1a+'� i)A s <br /> i <br /> Rehcashed by (Signature) Date Time e/_ r Rrce —ty (Signa } Dae Time <br /> Relinquished by (Signature) Date Time Received by (Signature) Date Time <br /> Relinquished by (Signature) Date Time Received by (Signature) Date Time <br /> Disposal Method <br /> Whae Copy Accompanies Samples <br /> Disposed by (Signature) Date Time <br /> Yellow Copy Sampler <br />