Laserfiche WebLink
CHAIN OF CUSTODY RECORD SCA Log Humber <br /> l <br />;Gent name Projector PON rn Analyses required <br /> Phone N V l <br /> ddress ' .E.S.T. <br /> rty,Sjtate.Zip Report attention <br /> C, <br /> Type, Number <br /> Sam led y <br /> Lab \ - <br /> Sample Date Time See key of <br /> number sampled sampled below Sample description containers /� r y� Remarks <br /> � - <br /> L- <br /> c ovy01 _ <br /> r <br /> Signature Print Name Company Date Time T. <br /> •L� <br /> Relinquished <br /> Received by <br /> >l <br /> Relinquished by <br /> Received by <br /> Relinquished by <br /> J I <br /> Received by Laboratory Li , Wo <br /> B C ANALYTICAL r Note:Samples are discarded 30 days atter results are reported unless other arrangements are made. KEY: WW—Wastewaler SU—Surlace Water SO—Soni <br /> Hazardous samples will be returned to client or disposed of at client's expense. SL—Sludge PE—Petroleum OT—Other <br />❑ 1255 Powell Street,Emeryville,CA 94608 {510}428-2300 NA—Nonaqueous GW—Groundwater AO--Aqua <br /> ❑ 801 Western Avon--- Glendale,CA 91201 (818)247.5737 Disposal arrangements: <br />