Laserfiche WebLink
.1+•..e. i '... �• r%max .°._r-. w.w4.,'u ,rsi.,�w ++r-.��arexni� ,,,dr;-.,,.�'+#�::s�an.[aaa.�ad�.7 : ,,,.�e.s•ax '�{a5i48asiR�er tie+aW .M` .w�- <br /> CHAIN OF CUSTODY RECORD <br /> i <br /> ® SAMP ER (signs ur <br /> .4pv/led GeoSys,�errrs <br /> �„r �� � 1 4191-E Power Inn Road,Sacramento,CA 95826 (916)452-2901 <br /> Phone: �!�� ! •Fremont •Costa Mesa •Sacramento <br /> LABOR T Ry' SHIPPING INFORMATION: <br /> �2.�1��kL1, _ Shipper <br /> Address <br /> Date Shipped �. <br /> TURNAROUND TUBAE: I kRa Service Used <br /> Attention: Eli �- Airbill No. Cooler No, <br /> Phone No. <br /> Reli uished.b signatures} Received by:(signatures) /Dante !Time <br /> / 1, �,� / i ,,/ ,,,j JNTd 1rrj <br /> Received for laboratory by: <br /> LA iORATORY SHOULD SIGN UPON RECEIPT AND IRET.URN A COPY OF THIS FORM WITH THE <br /> LABORATORY RESULTS <br /> Sample Site Date Analyses Sample Condition <br /> No. Identification Sampled Requested Upon Receipt <br /> J 1 <br /> .���q- J.;IbI� ��,7PN�L�Sr, brr,cwrc[/'�..f_j�f-.fIJ <br />