Laserfiche WebLink
r <br /> , r - <br /> E IT S. I <br /> * E A H. Qom t�►� <br /> 4 D .* I ENVIRONMENTAL CONSULTANTS W�r turn-around <br /> C CI CO <br /> ?F L'1 D 3E co <br /> 1 - CHAIN OF CUSTODY RECORD �' <br /> * m * PROJECT NAME: <br /> m <br /> * M 3oz d <br /> D * .- SAMPLER .signature} ; Number of y�4�a <br /> Qa <br /> m ( Containers/ <br /> 00 Ln Type of <br /> * o Date Time Sample Location Sample p <br /> �• rn * � Lab .D. <br /> �' �' s 4 as boo rnu3- aRss X <br /> ?� w :a <br /> ?� to D * - [ - <br /> * m z <br /> ?E OP t7 D <br /> * Ln m c, <br /> z <br /> * m * W <br /> * X A # a, <br /> * 1 * co <br /> * W 3 # <br /> I * ro m <br /> cci * Relinquished by; Date / Time Received b R linqu's ed by: Date / Time Receive by ' <br /> * D 1 9 a Com. } <br /> * ca I �F <br /> Company: ✓I /- b•I.?-ty <br /> co Company: L•r� Com an :��� `' Com an :� 5 <br /> * * Relinguished by; Date / Time Received by: Relinquished by; Date / Time Receive by: <br /> * z E <br /> * o a m <br /> M t% Company; Com an : Company: Company'! <br /> * Relinquished by: Date 7Time Received by: Relinquished by: Date Time Received by: <br /> * cn ; -lCom an : Com an <br /> * * Com an •: Company: <br /> NOTE: In preparing legal documents always use ink and signatures <br /> U. BOX 2242 <br /> • (7RQ) 984-1041 MFO!`cn rn oe 4n <br />