Laserfiche WebLink
SAMPLE RECEIPT (p L� <br /> Temp°C.'�40 Therm.l0#_�� <br /> Advanced Initlel��ql�Date_ o5d(000 CHAIN OF CUSTODY RECORD <br /> " GeciEnvircinmental, Inc. Time – Coolantresent: • <br /> P i{n. Date Page oJ—J—. <br /> 837 Shaw goad- Stockton, California-95215- (209)467-1006 - Fax(209)467-1118 <br /> Client Nu + NV4 In �a�{n'. U'nda Nu�� ) ProiectM <br /> A htlr DZI Tem Required <br /> 9 ►5 ur er Raac4 , v l� C 330 Phone Nurnber <br /> OaIL 6052. 3- 14% Zo -Lion-1°a v°sow` <br /> Sam : (S' ure) �Y� h� Irwoice: <br /> Project Name 1—rmk C(tv l7l , V1 C �� ��( �� �P � AGE J? <br /> O <br /> Number Description <br /> Sample Location Sample <br /> Date Time Nc. of cr <br /> CompV�arab. Air Solid Cane8. as.� ��\C ` / <br /> MW-3� SOsag S-S o8 1-748 �j VOikS W/ Ho F(}fry <br /> + /+nal- 4 0Z 0 - S-�-o� 15 <br /> Os0 a 5-5-o� <br /> MVS 5� 1 32 <br /> -0b <br /> t Mw -lob os 5-5-0� b �. <br /> Mw-13 g 5-5-OW y <br /> IUPC 5 �roY Z X r <br /> sin u <br /> q r �• <br /> y: nnure <br /> a• Ime <br /> Relinq ' ed b ipnalure) o s bb OfS <br /> Received by: (Signature) <br /> Mliny: (Signuura) Receival by Mobil* 4 Mb ens ew: <br /> Dalefriore <br /> Diepuc : (Signature) ^/ Data 1 <br /> jt( r Qg 1�- Laborer Dale/Time <br /> Method of Shipment: v-CoutELabor"^^atory�l Name <br /> �a � KIFF Anal � Ca' I <br /> special instruction.: r ►1G. Davi S C!} <br /> I hereby authorize the pertorinanoe of the above indicated work. <br /> CX106al ID 51. 18 I�2°I�a rrlivv''11 W�,1 Ti �� <br /> mail CON OF gg0y" k0 04cA -b A(rE <br />