Laserfiche WebLink
ASSOCIATED LABORATORI <br /> 806 North Batav2a it Orange, CA 42868 <br /> Chain of Custody Record i Phone (714) 771-6900 • Fax (714) 538-1205 <br /> 1 , ` company L C49. Pho C6-62-) fl1--3 58 A L Job No 99710 Page of <br /> Project Manager V &AS UM Fa ,56 <br /> �,Z�•-�,lQ Analysis Requested Test Instructions 8 Comments <br /> Project Name y,4 / . Prat0 <br /> lame <br /> and 0#r-QG4 /+YE <br /> B <br /> Address �d 1�J 1 o y. P G� � ` <br /> �T' ! Container G tali ����d J©�f <br /> Sample ID Lab ID Date E Time Matrix Number/Size <br /> Container <br /> Pres x <br /> M 3 02 zI oz 43:0 o 3 Vol 8's 994QvI o <br /> 2 M W k 3: FOP, vx rel#mj <br /> 3 M o Kb5 use,.,( IIJ <br /> 6 �3' C4. G 50aae- <br /> 5 M )�- M3: F-P# MfTwV0 81co <br /> 6 M w 9 � ' X X <br /> M W J0 D I X1XXM Er74444o(.; <br /> 10 g Tap VO 3 7Frg BUTfi 14,01- <br /> k MTZ6 <br /> ,z F�Talr <br /> 13 S y- �'r <br /> r �I , <br /> 14 <br /> ,5 <br /> Sample Receipt-To Be Filled By Laboratory Relinquished by 1 Relinquished by 2 Relinquished by 3 <br /> Sampler <br /> 5F ( L4� � r577t}97� <br /> Total Number of Containers ' Property Cooled /N/NA Signature n Signature Signature <br /> . 1� <br /> Custody Seals Y/ NA Samples Intact Y/ !NA Printed Namen Printed Name Printed Name <br /> Received in Good Condition N Samples Accep Y N Date Time -v Date Time Date Time <br /> 02 2.(•02 18,00 <br /> Turn Around Time Received By , Received By 2 Received By <br /> GOF� <br /> Signature Signature Signature <br /> Normal Ll Rush Q Same Day LJ 48 hrs Printed Name Printed Name PV d5 N6 Printed Name <br /> ❑24 hrs ❑72 hirs " <br /> Date Tyne Date Time I pate Time <br /> Distributwn Whits Laboratory Canary-Laboratory Pink Project/Account Manager Goktanrod-Sampler/Originator <br />