Laserfiche WebLink
i i [ i [ f f i [ [ <br /> 420204 • 5 !)� <br /> RTrEMA*n0NAL ANALYSIS REQUEST AND Reference Document No. J 0 9 Cl ,fm <br /> cowPoTECHN°noN CHAIN OF CUSTODY RECORD" Page 1 of I D <br /> Project name/No. 1 Ycl-mow F-r�LVD5or Samples Shipment Date ' Z "x`92 Bill to:,D ` COZF'. _ v <br /> Samp'e Team Members 2 -D_ N_ Lab Destination 7 �� <br /> Profit Center No. 3 �I _ _ Lab Contact ` CArzo al 'E35 -A,_ -- <br /> PrjW-t Manager° c. 8c>a� - - Project Contact/Phone 12c_ lam•)3n_ -wor7 10 _—_ - --_ _--, <br /> — - -- <br /> RepA5 f+gcr�� <br /> Purchase Drder No.--_- -. -arrier•/Waybill No. �3( .) 86 y ave ort to: <br /> Rem iced Report Date 1 � --- --- ---- <br /> Sample 14 Sample Is Qate/Tinle1 Container'7sarnplelf Pre- 7-RW <br /> equested Tog" 20 Careditien on Dis v< 12 <br /> Number Description Collected Yok"M se+vatirram Rene' t Record No. <br /> -i <br /> X31-y �o�t ' �r uzz 1JQil3 ev(6* Y°cl�+� , 'YNlo M <br /> sr33-z Ic <br /> 50q _q <br /> 1 <br /> Special Instructions: 23 <br /> Possible Haz Idertification: 24 Sample Disposal: 25 <br /> Non-hazard--:3 -j Skin Imitarr Poison B Unknown IJ Return to Clientij Mposal by Labe Arch-ve_-_.—_ (mos o <br /> Turnarouno Time Required: zs QC e%d:27 (D <br /> Norma " Rushlj l j III._j Projei=Specific(s c ):___ C) <br /> -- o <br /> 1. Relinquished b-28 A Date:_ E'- 3 qz 1. Sec ed by 28 _ _ _ ,,, <br /> t�g�a�relMFiatio,) -cwzFTime: i��15 ❑c�Alfi�3wr) Tern o <br /> Relinquished by Date. _- eceivettby Date:__ <br /> MUNI Time: <br /> 3. Relinquished by Date: 3 Received by Date: <br /> tsgnaxne/arfi"atio,) 9nmu"/Asr,3corl Time: 11t.6 0 <br /> m <br /> Comments: 29 <br /> 0 <br /> MCA 3A, <br />