Laserfiche WebLink
AIR TOXICS LTD. 180 BLUE RAVINE ROAD, SUITE B <br /> FOLSOM, CA 95630-4719 <br /> AN ENVIRONMENTAL ANALYTICAL LABORATORY (916) 985-1000 FAX (916) 985-1020 <br /> CHAIN-OF-CUSTODY RECORD 1 ` J` ; 11 <br /> Page _ of <br /> Contact PersonMPProject info Turn Around Time <br /> Company <br /> PO # =�'� LIS <br /> Address .� Ll Normal <br /> `City Statea Zip 2� 'Project# — ❑ Rush <br /> Phone L - 0/.;2-3 FAX BSIv - 57F — Project Name AU0 - q t Specify <br /> Collected By Signature <br /> S'L <br /> L <br /> Lab <br /> Field Sample 1 D Date & Time Analyses Requested Canister Pressure/Vacuum <br /> Initial Final Receipt <br /> A?A T <br /> L - - <br /> Rfished B [ azure) Mme 1,670 PnntName Notes <br /> Ile <br /> Rehngwshed By i alure) Dat a Received By (signature) bale/Time <br /> Relinquish By(signature) Datefrime Received By atur ,Dat e <br /> U ATL I6TO <br /> Shi of Name Air Bill I ed By. te/Ttrha Tem (°C) Conditto Gusted Seats Intact? Work Order# <br /> [Only <br /> b `�/�(� `1 ,,// n <br /> e t, t Int t iN�4 Nf� l t�_j' V ,(? Yes No None /A <br /> Form 1293 rev 06 <br />