Laserfiche WebLink
EIIteco Pas• I of I <br /> CHAIN-OF-CUSTODY RECORD <br /> SAMPLER:(Sig lure �J <br /> �.f 4A^. '_ i n- Data Shipped Carriar <br /> Phone - A- Ste, Alrrill No. Cooler No. <br /> SHIP TO: SEND RESULTS TO: <br /> Enseco-Cal Lab Client Ne=e <br /> 2544 Industrial Bird. Conm„ar __ ,,,,��P, Y'd r T-Q--' <br /> West Sacramento, CA 95691 Address <br /> (916) 372-1393 <br /> ATTENTION: `_k0 Phone <br /> PROJECT NAME I l L.S S . 1Y1a„ASA, I„ulpr,,,•pROJECT NO. I E.SZO-001 -03 P.O.NO. <br /> Relinquish d by: (Signature) Received by: (Signature) Date Time <br /> ) /lc. (ems oc� <br /> Relinquished by: (Signatu a Received by: (Signature) Date Time <br /> 'tclinquished by: (Signature) Re ived at lab by: (Signature) Date Time <br /> n <br /> Relinquished from lab by: (Signature) Received by: (Signature) Datc Time <br /> ANALYSIS REQUEST <br /> Sample ID Sample Date/Time Sample Condition <br /> Number Description Sampled Analysis Requested Upon Receipt <br /> Z 4 -9 .% <br /> 1Z: 1L✓�� <br /> A-P” 13:m <br /> 4 O-4" 13:30 �1r1 <br /> Special Instructions/Comments: <br /> rot �d ro cc�v% . <br /> k� CO¢ e"r I c b re.�Ct-�- d �c �-►�a� y'too� T , _Z . z6�' <br /> N T • ` T -AOUEOUS SAMPLES MT-T- TIF R TURNED 0 CLIENT <br /> Expected <br /> oalytical Immediate <br /> A.T's: Attention (g00% surcharge) RUSH (so-t00% surcharge) Standard <br /> Cal Lab ID Number: (for lab use only) <br /> Client Retains White Copy Only (Revised 1/87) <br />