Laserfiche WebLink
� III k 4 <br /> CALSCIENCE ENVIRONMENTAL r 1 <br /> LABORATORIES, INC. I CHAIN OF CUSTODY RECORD <br /> Kff AnaWical Note <br /> 7440 t_INCOLN WAY 1 I I 1 <br /> GARDEN GROVE, CA 92941-1432 k Equlva Was cUispasal FoITT1 Page 4B 'fin Analyses Date 1��_ (-` I <br /> TEL (714)895-5494 + FAX (714)894 7501 I knt No Page _} }of _ <br /> I <br /> LABORATORY CL IENT '' i CLIENT PROJECT NAME I NUMBER F►$va—L"Ll,K11 U, I 4 ,C <br /> I ff Malytl <br /> j ` <br /> ADDRESS ; � i <br /> 7_'(10livc Drive Suite D � � � PROJECT CONTACT J(-,cl Kitt` LAD USE LY <br /> CITY STATE I " ZIP I <br /> l]d.15 I (�A I 95616 <br /> I 1'i <br /> TEL FAX I EMAIL III SAMI PLEA(S) (SIGNATURE) COOLER RECEIPT <br /> ' I ' I <br /> (53(9} 297-4800 I4 (53(1 297-4 i } TEMP OC <br /> TURNAROUND TIME I T]IL.r I 1 I y C, ; REQUESTED ANALYSES <br /> ❑ SAME DAY ❑ 24 HR ❑ 48 HR ❑ 72 HR 5 DAYS ❑ 110 DAYS - - - <br /> n <br /> SPECIAL REQUIREMENTS (ADDITIONAL COSTS MAY APPLY) <br /> ❑ RWQCB REPORTING [ ARCHIVE SAMPLES UNTIL 1 I <br /> SPECIAL INSTRUCTIONS p I = T v <br /> E <br /> SAMPLING I VA or ! _ v `, G r <br /> my 5AMPL>=ID LOCATIpH/DESCRIPTION �uTNX CONT _ '4 <br /> t' <br /> I <br /> wE I 3 ISI 1.1TE�. X x <br /> I� € V I � <br /> I <br /> 3 I l l I If <br /> Relinquished by (5ture) I Received by (Signature) <br /> �_y wr_ Date Time <br /> -r �r ��/ E�4 I 1 //o gyp/ 1?e>c) <br /> Relinquished by Signature) Received by (Signature) Date Time <br /> 3 <br /> Relinquished by (Signature) Ii Iv for bora! i by (Signature) le Time <br /> tj <br /> DISTRIBUTION WhIte with Mal report,Green to File Yellow and Pink to Client 1 1 10/01 IdWevision <br /> Ol.o..n/.li:a.none. 1.«d O.9'2 We. <br />