Laserfiche WebLink
ASSOCIATED LABORATORI1& LA\. <br /> 806 North Batavia a Orcmcge CA 92868 <br /> Chain of Custody Record Phone (714) 771-6900 a Fax (714) 538-1209' <br /> y Ph / <br /> Compan Q f� 0 ! � ), —3-6kI A L Job No Page of <br /> � <br /> Protect Manager f l &—V` rax c?V— 7-5,( a Analysts Requested Test Instructions &Comments <br /> Protect Name �h n J � Ploledt N <br /> Siteand Name <br /> and <br /> Address n r+ <br /> Sample ID Lab ID Date Time Matrix Container Pres {� <br /> �i Number/Size <br /> 1 � � � D3 •2�. OZ 2tn rT P JrFp4�P <br /> 2 <br /> 3 <br /> 4 <br /> .00 <br /> 7 <br /> S <br /> 9 <br /> 10 <br /> 11 <br /> 12 <br /> 13 <br /> 14 <br /> 15 <br /> ` Sample Receipt-To Be Filled By Laboratory Relinquished byLn� Yb Relingyitsh�py, Relinquished by 3 <br /> Sampler �ir'YJR� i�� ` (j-t`� ��i .� <br /> Signature Signature Srgnature <br /> Total Number of Containers j Properly Cooled Y/N A <br /> Samples intact / /NA Printed Name Printed Name Printed Name <br /> Sam <br /> Custody Seals Y N/NA p21 C4 }r}QDP r-s L°.V <br /> Received in Good Conddia Y/ Samples Acte ted !N oatl3 Time Date Time Date <br /> 74,07— Time <br /> Received B <br /> Turn Around Time 1 Received By 2 Received By <br /> / Signature Srgnature Signature <br /> kd Normal U Rush *Same Day ❑4s hrs Printed Name Pnnted Mem f 10 Printed Name <br /> ❑24 hrs ❑72 hrs �f <br /> Date Time Date Time <br /> Date Time <br /> ni�lnhntinn While I ihnratnry Camry L ahnratnry Pink ProiertlAcrrnmt Manaryer Gntrlanrnd Sumpter/Origln>ttnr <br />