Laserfiche WebLink
ASSOCIATED LABORAT4RI£S <br /> 806 North Batavia ■ Orange, CA 92868 <br /> Chain of Custody Record Phone (714) 771-6900 • Fax (714) 538-1209 <br /> Companyt rt L Phone 5 —V } <br /> L �3:JQ A L Job No Page of <br /> Protect Manager Fax <br /> �ts2 Analysis Requested Test Instructions&Comments <br /> Protect Name 4C. /� Protect <br /> Site Name <br /> and � � W p�t../[ �C+ c- "+YA— <br /> Address C4 - q6'2-0- <br /> Container Q <br /> i CJ <br /> Sample ID Lab ID Date Time Matrix Number/Size fres p. <br /> ' M w -� ©5 05-�� [2.44�f0 h-VOA 0 CL- <br /> 2 m W Cry 9 )2 ;fib rC X X� X, P-OR doewcpoot4its <br /> 4 <br /> 5 "X K X X, 226cq <br /> 6 fX- <br /> XI <br /> �3'kn XXX 2- F2,PfttNoL- <br /> 00 <br /> PC- <br /> 12 <br /> 13 <br /> 14 <br /> 15 <br /> helinquiSample Receipt-To Be filled By Laboratory ampler hed I�y4 M- 1 Raltngs, n� y� I Relinquished by s <br /> Sampler 1� Cry ssNf <br /> Total Number of Containers 3 I Properly GooY/N/NA Sign Signature , Signature <br /> Custody Seals Y I N/NA Samples rota Y/N/NA Pnn�ed <br /> am^i Printed Name Printed Name <br /> Received in Good Condition Y/N SamplesAccep Y/N Date r (��Time �r- Date Time Date Time <br /> Turn Around Time Recei��y IYI� 1 Reserved By 2 Received B� 3 <br /> Signature Signature Signature <br /> 0�-r2tq t Chi -1 <br /> Normal ❑ Rush El Same Day ❑48 hrs Printed Name Printed Name Printed Name <br /> D 24 hrs C7 72 fins - <br /> p Time Date Time 1 Date Y Ti e <br /> MDistri While tory La Fink VACC pager prod M/Ong — <br />