Laserfiche WebLink
i m m i m i m m m ! m r <br /> CREEK <br /> ANALYTICAL <br /> 18939 120th Avenue M E,SuRe 101 •Bothell,WA 98011-2569 <br /> CHAIN OF CUSTODY REPORT Phone(206)481-9200•FAX(206)485-2992 <br /> [/ <br /> CLIENT 5 P_ K �7 <br /> REPORT TO: FAUr- SAME DAY (2-8 HR.) RUSH ( +150X) <br /> ADDRESS 15-3 ` "jO T-4- T NEXT DAY RUSH ( +100X) <br /> BILLING TO: 2 DAY RUSH ( +80X) <br /> P O NUMBER 3 Z S^ 7 3 DAY RUSH ( +60X) <br /> PHONE C J'3 FAX HCA QUOTE e <br /> T jj jlj;( 5 DAV RUSH ( +4OX) <br /> PROJECT NAME FA+"O�JD L_4merzr - IJ IkrvjEe-A, rot?"1,4— Q ANALYSIS REQUESTED 10 DAY STANDARD ( LIST PRICE) <br /> PROJECT NUMBER: ��SZ�Ej 2 4 ��ja� a COMMENTS i <br /> SAMPLED BY: aI1AJlFylr PRESERVATIVES USED LABORATORY <br /> tJ <br /> SAMPLE IDENTIFICATION- SAMPLING MATRIX 0 OF M q q NUMBER <br /> NUMBER OR DESCRIPTION DATE / TIME (u,S,O) CONT. 3 , ° LO <br /> 1 �l���lll�! 1!lh�IL� I� fw �/ �( 110.° rcOD� C�u�c?u!t rYr/IcViD <br /> I` �rrrtr�rn <br /> 2 S l,-j:- 1?1 by e_ jArL) 4jG 2 C7L' -+ .' X F es° xpo— .4116wv <br /> 3 J 12 K- W 3 ' Mr,,v 43-0�p�, 1/1.� Q— y. � *4r°° •p . Cs}u�ot11 <br /> ..,4 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 TOTAL 0 OF CONTAINERS l Z- <br /> 10 RECEIVED? 0"�z TF4c <br /> RELINQUISHED BY: J + r DATE: 4(� 1 � RECEIVED BY: DATE:04 Qcf•cte- <br /> FIRM- f S L7z-- TIME-FIRM, TIME: <br /> IQ <br /> RELINQUISHED BY: DATE: RECEIVED BY. DATE: <br /> FIRM- TIME. FIRM TIME: <br /> SAMPLE RECEIPT INFORMATION. TAINER CMDITIONZ• VIOLATED COOL ( 4° C)7 ES NO <br /> CUSTODY SEALS? GOOD VIOLATED NOT USED HAZARDOUS SAMPLES?: RI YES; DESCRIBE ON BACK PAGE OF <br />