Laserfiche WebLink
i <br /> 2795 2nd Street, Suite 300 <br /> Davis,CA•�� 956116 ij Lab 530 297 4800 t� <br /> ANALYTICAL ccc Fax 530 297 4808 I Lab No _$b�� Page—L or <br /> Project Contact Har py orDF To) Californi'� EDRF Report? ❑ Yes E]No Chain-of-Custody Record and Analysis Request <br /> Company) dd ess <br /> Z GetemmmededxxnotMWXI* toow eehsscdMo�/O <br /> Sampling,Company Log Code <br /> a 4 <br /> Analysis Request � <br /> one No FAX No Global ID in x <br /> I G N yW <br /> I NN } <br /> Project Number PO No EDF Deliverable To(Email Address) g CO m <br /> co 0 <br /> Proje Name PI Sampler Signature m m m r a o <br /> 11 <br /> / CO co w <br /> Project Address Sampling Container �E Preservative Matrix m N CO <br /> I`fU��` o o 2 -a m o I� N w <br /> W I " W W <br /> c I U z w 0 ¢ A a a a 0 0 m a o r <br /> Sample Designation 7DateTime a � a[ z z v z � vj m m � F I'_ LO r- to <br /> � w � <br /> ' <br /> X/ 7,?,A (v IX 'II If ' X <br /> A41618 aj► ��a I ,111 1I IX o <br /> t <br /> I <br /> 1 if <br /> {II I <br /> Rel by *Dte Time Received by Remarks <br /> U �01 i�Relinquished by Time Received by <br /> I� 6 <br /> Relinquished by Date Time <br /> ( Received by Laboratory y/�.�r�r_ Bill to <br /> i Drstb1 <br /> Form <br /> InF121001(119 <br />