Laserfiche WebLink
z <br /> w <br /> 1 <br /> GAIN OF CUSTODY RECORD,.,, <br /> %MIPLER gna �4,BoR/!�d (s'�OSrS+'B/!y5 <br /> 11251) Nlission Illvd. CA 414531) 1x151(�5i-'{�lllh <br /> Phone: y 0;$/ �. <br /> SHIP T12UE77C <br /> ' SHIPPING INFORMATION: <br /> Stripper -- <br /> Address ....._. .- <br /> Onto Shipped <br /> Shipment Service <br /> ATTENTION: 22 T&,V Alrbill No. Cooler No. <br /> Phone No. <br /> Relinqui Od bi ., urn Received by:(Sig+xnus) Date Time <br /> r <br /> Rel guisisad b . ; gnatury Received by:(Sirmwe) Onto Time <br /> Relinquished by:(Srsnamml Received by:(84wt +el Date Time <br /> Relinquished by:(Sprue) Recely eriaboratery try':(signaturo) Datta Time <br /> -ialysis labaratovy should complete "Sample Condition Upon Receipt,** section below. sign and return top <br /> copy to: APPLIED .GEOSYSTEMS., 43255 MISMON BLVD:'. FREIdi31'FZ2 -CA. 94539 <br /> Semple Site/Sample Onto Analysis Sample Condition. <br /> Number Identillcation Sampled Requested Upon Receipt <br /> �3 16' 711C f $TE6 ,2 <br />