Laserfiche WebLink
i ! • <br /> CHAIN OF CUSTODY Page-4�Lof <br /> CONSULTANTS NAME CONSULTANTS ADDRESS <br /> 0 <br /> BTSR - Blame Tech Services, Inc 1680 Rogers Ave, San.lose CA 95112 <br /> BP SITE NUMBER GL013AL IO SP SITE!FACILITY ADDRESS CONSULTANT PROJECT NUMBER , p <br /> 11194 ITDO07700011 2375 Tracy Blvd .Tracy <br /> GONSULT'ANT PROJECT f IANAGER PHONE NUMBER FAX NUMBER CONSULTANT CONTRACT NUhtBER � <br /> Cindy Magyar (406)S73-0555 x 221 (408)573-TT71 <br /> BP CONTACT 6P ADDRESS PHONE NUMBER FAX NO <br /> Scott Hoolon 295 SW 41st Street, Sade N,Renton WA (L25)251-0509 425 251-0736 <br /> LAB CONTACT LAB CONTRACT# LABORATORY ADDRESS PHONE NUMBER FAX NO <br /> Pace-Paula Klrtle 400-6-21124 900 Gemini Ave, Houston,TX 77058 (281)488-1010 261 48B4661 a <br /> -ONTACT REOUE.STIN3 RUSH TAT(Print BP Gantad Mame) RUSH REQUESTED OF(Prcnl Cansu t M Contact Name) OA11MME SHI)Ph4ENT DATE SHIPMENT METHOD <br /> z <br /> TAT ❑ 24 HOURS 1349 HOURS El72 HOURS Slandard7 or 14 Days ANALYSIS REQUIRED AIRBILL NUMBER <br /> x <br /> WNTA HERS PRESERVATIVE <br /> m <br /> Lu cn $ <br /> SAh1PLE➢ESCRIPTI,ON COLLECTION COLLECTION MATRIX a m <br /> GATE TIME SOILWATER fJO TYPE LAB w p COMMENTS [� <br /> (VOL) SAMPLE trm $ 0c Lu cn <br /> h ; <br /> n <br /> l/T Z ivy - 0 (J L <br /> ryi <br /> r-, <br /> /+-m - Dfl L3 <br /> r y, <br /> ?�^ rSa.� <br /> J <br /> i <br /> SARfPLED BY(Please Pnrt Name) SAMPLED BY(S,RrWW e) ADDMONAL COMMENTS <br /> RELINQUI SHED BY I AFMIATI ON DATE TIME ACCEPTED BY/AFFILIATION (Pnnt DATE TIME <br /> pi kA Name I Slgnaturo) Name I ftnalure) <br /> b <br /> o <br /> N <br /> 1 <br />