Laserfiche WebLink
MI.r 7r,.L QUAL11YANALYTICS fRUSH <br /> —J <br /> R <br /> CHAIN OF CUSTODY RECORD <br /> PROJECT NUMBER PROJECT NAME CLIENT ADDRESS AND PHONE NUMBER FOR LAB USE ONLY <br /> CLIENT NAME t <br /> L N-r� ANALYSES REQUESTED LAB#: <br /> PROJECT MANAGER COPY TO: CO A PROJECT NO. <br /> N B <br /> �M IZAY SFp T fi `�r I ACK VERIFIED <br /> REQUESTED COMP.HATE SAMPLING REQUIREMENTS A V <br /> +rte LS SDWA NPOES' RCRA OTHER N Q D GUOTE�. BS <br /> I~ ❑ ❑ ❑ E <br /> C G S RNO. SAMP PG OF <br /> O R O S <br /> STA M A I SAMPLE DESCRIPTIONS <br /> NO. DATE TIME P B L (12 CHARACTERS) REMARKS <br /> 4*7- <br /> is-45— <br /> rs.. <br /> w•��y,sC / . <br /> 8—D-n <br /> SA BY AND DATE/TIJAE R EDAYDATE/ ME HAZWRAP NEESA Y N <br /> �3 QCa <br /> . <br /> RECEIVED DATt/TIM9 RELINQUISH,E... Y: D TEMME COC ICE <br /> ANA REQ TEMP <br /> RECEIVED BY.' DATE/TIME RELINQUISHED BY: DATE/TIME CUSTSEAI Ph r <br /> SAMPLE CON . <br /> C!� RE ENED BY-LAB: .. DATE/TIME SAMPLE IPPED VIA AIR BILL# <br /> UPS 4 BUS FEE)-EX HAND OTHER <br /> j REMARKS ENTERED COC <br /> INTO LIMS REVIEWED <br /> REV 6189 FORM+.^ <br />