Laserfiche WebLink
ASSOCIATED LABORATO"' <br /> i • 806 North Batavia • Orange CA 92868 IS <br /> Chain of Custody Record Phone (714) 771-6900 ■ Fax (714) 538 1209 _ <br /> 9g! _ <br /> Company �j /! f j t ri ��C✓ P cJ �ZZ <br /> - A L Job No Page Protect Manager C1 1 v,� F 5 r � Analysts Requested Test Instructions 8�Comments <br /> Protect Name Protect# <br /> L e( L Q }� <br /> and Site Name x1Y�'I �'/I ��L l a 1't <br /> Address S77)C4,—"*7.O1 j C15- 2,09 <br /> 15 . 09 P <br /> Sample ID Lab ID Date Time Matrix Container Pres �� g <br /> Humber/Size X <br /> ' O LFA i 2, 9. old 0 O42o 3 lr 4a., X XX I <br /> j ice' 4 12. ,o j j tlrt) d 3 V D A �4 e-L ?,.(X ! 6'T 'f04) 3' 16 Q ,s <br /> 2 ,QA 11i)z3VyA7 HCL X <br /> 5 <br /> 6 <br /> 4 � + <br /> 9 <br /> 1 t] <br /> 11 <br /> 12 <br /> 13 <br /> 14 <br /> 15 <br /> FSampler <br /> uished by 1 Relinquished 2 Relinquished by 9 <br /> Sample Receipt-To Be Filled By Laboratory � F? 1 ETotal Number of Containers j L Properly Cooled Y/N/NA re y� Signature Signature <br /> Custody Seals Y/N/NA Samples Intact Y 1 N/NA Printed Name 4����+� Printed Name Printed Name <br /> .>r <br /> t 1f R+&"'r <br /> Dat ^ r? �! �� r T me <br /> Received m Good Candttion Time Date Time Date <br /> Y/N Samples Accepted Y/N 4 q <br /> RaceNad ay, 1i Received By 2 Received By 9 <br /> Turn Around Time fir. _ <br /> Signature Signature/, �t ,. Signature <br /> —/ ❑Saute flay ❑48 hrs Printed Name Printed NameVK1\V'V "-I' Printed Name <br /> �d Normal Rush 24 hrs LI 72 hrs <br /> Date Time Date Time Date Time <br /> r <br /> Olsinbutton White laboratory Canary Laboratory Pink Project/Account Manager Goldenrod Sampler/originator <br />