Laserfiche WebLink
M Mir m OW, M i M 0W+ M so <br /> f/JC,L��n r� SIDE 2 FOR <br /> COMPLETE <br /> 1`'Iaf CHAIN OF CUSTODY' RECORD 32567 <br /> INSTRUCTIONS <br /> r <br /> Ship To: '- <. -- - - Project Name:.4Zz'. .-,f�'. �`� -��/F F - FOR LABORATORY USE ONLY t1 <br /> _ Metlhvd� <br /> Address: / �z. r f-t� �� r Project Number:. G%<�G/ `{Cf—r C[- Laboratory Project# �� 4112 <br /> ,� �r, r<�, Storage Refrigerator ID _E 2y 1 I 418.1 <br /> Project Location: (State) - I �'� <br /> Storage Freezer ID 418.;short MNhad <br /> 5022 <br /> Sampler Name 1 Signatiire,o' J PPE Worn in Field ! 503E <br /> 5242 <br /> Bot <br /> Re Tgmshed By Date/rime J Deceived By or Med)od of ipment/Shiprnent I D Datefrune am <br /> R gtushed � ) /U Date rime Received By or ethod of Shrpment/Shtpmern 1 D �„�.�. DateJThne 810 <br /> /Y fy •. f 624 <br /> Rehnguis �� Datefr-ne Reoctved or eth.o�d�55of Stu ipmem LD DateJrune gp q0 <br /> �( S f' Bois <br /> 8015 Mod <br /> Sample DisposalLevel of D 1 ❑ z ❑ 3 ❑ 4 ANALYSES REQUESTED �1 <br /> (check ane) am <br /> (see Side 2) Write to Y 8W <br /> Laboratory Standard 5 6 7 Analysts Method 8 <br /> 1000 <br /> am <br /> ❑ Other SAMPLE INFORMATION ~ ` '3 <br /> i ftWnay <br /> STEM <br />' n <br /> FOR LUO"WRYUSE ONLY Sample ID Description <br /> Contamer(s) Horror Pres `� CLPsae 2) <br /> UbID Number Date Tune Locator Depth # Type Type Type TAT t— L }L Color <br /> / coridualY <br /> I r 17 f ! ! t , CyanWe <br /> A, f0 / /r � G! X Flaslrp" <br /> Fluoride <br /> 2 C ' f a t F General Mitroral <br /> rr Mdab{writ.SParhC <br /> 4 I c ! ,• i ,{t" / / !.i — [j Vr X mete)a Ind al• <br /> ! aS <br /> 5 Mmals 1PP* <br />' / Metals Titov 22: <br /> TTLC L" <br /> _ STLC LOW <br /> 7 t G ! n /Y /: /1/ { x (See Side 2) <br /> Nhab0 Lad <br /> 9Orp Mercury <br /> P«nerd Moutwe <br /> 1Q Porosrd Solid <br /> Perchlorate <br /> PH <br /> Special Instructions/Comments Container Types A=1 Liter Amber TAT(Analytical Tum Around Tune) PhosOWvs <br /> $=$toss Tube <br /> C--Cassette 1=24 hours 2=48 hours Phosphorus <br /> G---Glass Jar P=Polyethylene 3=1 week 4=2 weeks sulhdea <br /> 0--Other V=Voa Vial 0=Other TCLP <br /> VOA <br /> Semnoo <br /> FOR LABORATORY USE ONLY, Sample Condition Upon Receipt T C n R SEND DOCUMENTATION ANDRESULTS TO(Check one) P�Metals <br /> Protect Manager/Office (< Trus Haidnsas <br /> ❑ Client Name Total sorra. <br /> TPwD <br /> �, 7_ T <br /> PHVG <br /> Company ��_ ,f czd Pr, �� TS8ss <br /> Turbidity <br /> Address � �� 1 <br /> � -'S�**Total«Diwotvsd <br /> Phone FAX <br />