Laserfiche WebLink
Chain—of --Cusfod —Record <br /> Facllity NumberIr <br /> .. Contort (Nome) <br /> ' Fovluty Addr,s.._y707_ GLZW <br /> c-._.e SrA',�1!"` � (Phone) <br /> Consultant Project Number I7 Il �Ge <br /> Laboratory Name <br /> TOSCO Consultant Nome Prr ✓ G'^ J' c <br /> Addres / S!✓✓� T sib/C{, Cs �e�/n ��j �jGB Laboratory Release Number— <br /> Samples <br /> rO <br /> rte.r��w/y cater __ <br /> z0°6peiCijjpift"40tl 3YG7 �rolc✓ CG%° 4f t�eYG Cinc4v (C�du�c C Samples Collected by (Name) ,� <br /> r'"°"""°' Project Contact (Name) W <br /> Colleotlon Date <br /> (Phons)glt 63,1. 130C, (Fox Number) SlInature <br /> Analyses To Be Performed DO NOT BILL <br /> TB-LB ANALYSIS <br /> k E S 11 a o1 ° 1 C <br /> 25 <br /> z Cn 1 1 1 r a <br /> 40. �q = io 0� CN LZ <br /> Remarks <br /> TB-LB <br /> 133 �c►u_ <br /> f Oz.s 1 6 Ak A 4 A 6V cry <br /> Rellnquished §r Pgnat ) Organization Date/`Rme Reoelved By (Signature) Organization Date/time Tum Around Time (Circle Choles) <br /> G—R Inc. -W,5 <br /> 24 Hrs. <br /> Rdlnqulshsd 8y (Signature) Organization Dote/Timelr, ReceNed By (Signature) Organization Dot*/'nme 48 Hrs <br /> lv — !1 G-7.r7y 5 Days <br /> Days <br /> Rsllnqulehed By (Signature) Organization Date/'11me y Realeved For Laboratory By (Signature) I}gte10 <br /> Co ♦mats <br /> S <br />