Laserfiche WebLink
' BILL 10 � I p # 11398 <br /> w ���-t�-E7Q-�►„�S <br /> ,/A 8084 0LD AUBURN ROAD CHH CONSTRUCTION <br /> / � + CITRUS HEIGHTS CA 95810 ❑ SERVICES INC LIC #608406 JOB <br /> Irk (916) 723-1778 <br /> ■e. ....�.. . il uc #6053$0 Wil OLD AUUURN ROAD CITRUS HEIGHTS CA 9S6LO <br /> CHAIN OF CUSTODY P ° # <br /> JOB --- <br /> ' PROJECT MANAGER L[�t' SAMPLES COLLECTED BY <br /> SAMPLE TYPE <br /> SAMPLE TYPE ANALYSIS <br /> Q SAMPLE LOCATION DATE TIME NO CONTAINER(S) REQUIRFD <br /> a SOIL AIR WATER <br /> B� X mw <br /> � i 3x rt <br /> loss X s <br /> wgg X X3 <br />�� X t3�2 8F► -- <br /> � x � <br /> Xix <br /> 4215 per.-. <br /> z <br /> PRINT N TER SIGNATURE <br /> RECEIVFD BY DATE/TIME <br /> Y� <br /> REL QU1SHED AY RECEIVED BY DATE/'IIML <br /> ' E ELINQUISHED BY RECEIVED BY <br /> DATE/TIME <br /> RECFIVED FOR LABORATORY BY DATE/LIME <br /> ' METIIOD OF SHIPMENT <br /> t <br /> ' DISPOSITION <br /> STORAGE ❑ REFRIGERATOR ❑ FREEZER <br /> RN AROUND TIME SECURED <br /> ❑ 24 HOURS ❑ 3 DAYS ❑ I WEEK2 WEEKS 1:1 ElYES NO <br /> NOIF PLEAS[-' HAVE FACH DATA SIIEE'I SIGNED By C FMIST <br />