Laserfiche WebLink
s IS = M = i = M i M rMew <br /> �lr tail I• <br /> 720 Oiive Drive, Suite D <br /> /FF Davis, CA 95696 <br /> Lab 530 297 4800 <br /> ANALYTICAL ctc Fax 530 297 4803 Lab No 2Page I of <br /> Project Manager Phone No <br /> Toe K q w%'lz 016) 15 4 3 Ly 0 Chain-of-Custody Record and Analysis Request <br /> Company/Address FAX No <br /> Rqmsi Z Ehvii~aOmelt 'il ( 94) <br /> Analysis Request <br /> Project Number P 0 No Email Address m x <br /> EDpd# E) xfs Eldoc ❑other w a N <br /> Project Name Sampler Signature CO °° m o 3 �+ <br /> sati Toa vt'q CatWtil; Ct41erek m o <br /> Go <br /> m m a <br /> Project LocationW o W � � ,� w o �, <br /> w'; + fe v3 L�h( SfiGC(K c o m ry v y c <br /> m 2 T m <br /> Sampling Container Preservative Matrix _ Zo a s °� 0 7 0 1 <br /> Q m C7 vii $ W aNi aNi aNi <br /> O W a z c r m CO �' r <br /> Sample o X M M <br /> > > eq W W 0VJ ro Of N N N <br /> Designation a U z V 0 Q O a a a o o <br /> T z ca aroi <br /> Date Time v r _ C/) m m r r- r n n r w <br /> CK 6 - lit 1 3t510-L 1010 <br /> ceY 5 --I5 1145 x x x x x x 17, <br /> CNF 5 - 110 i>LO 3 x X X X X X <br /> CPT 5 - ON NIS 3 x X X X X X i s <br /> W15- l�t5 1?00 3 X X X x X X 5 <br /> Relinquished by Date Time Received by Remarks <br /> Relinquished by Date Time Received b� <br /> Relinquished by Date Time Received by Laboratory Bill to 11 o wi d i . <br /> 08 o z C"zs -��•-� Kr �� <br /> Distnbuhon White Lab Yellow-File Pink Onginator Formslcoc 062801 fhg <br />