Laserfiche WebLink
blow <br /> CHAIN OF CUSTODY No.O 7 2 0 5 5Page of T.CONSUL NTS N E ADDRESS CITY STATE ZIP CODE <br /> ,r <br /> BP SITEF NUMBER '�11 BP CO ER ADDRESSICITY CONSULT NT PROJECT NUMBER <br /> tv,.C,-.4 0—0-�5– —1 J L, <br /> CONSULTANT P ECT MANAGER PHONE NU BER FAX NUMBER <br /> ! CONSULTANT CON7RArG�T NUMBER <br /> �� l U 1 i j .—[ - �C � t` � � � � �11 <br /> BP CONTACT BP ADDRESS PHONE NUMBER FAX NO <br /> \,�(,I ONV U..1 <br /> LAB CONTACT LABORATORY ADDRESS I PHONE NUMBER FAX NO <br /> 's r �i�zxh S <br /> S MPLED BY(Plea Print NameSAMPLED (Signature - SHIPMENT DATE Q SHIPMENT ME <br /> + 1 <br /> (p <br /> AIRBILL NUMBER <br /> TAT 24 Hours ❑ 48 Hours ❑ 7 We INStandard 2 Weeks � ANALYSIS REQUIRED <br /> 3 4 q5 4 lad <br /> COLLECTION CONTAINERS PRESERVATIVE U. <br /> + , <br /> SAMPLE DESCRIPTION DATE MATRIX SOUWATER TYPE LAB r COMMENTS <br /> COLLECTION <br /> TIME (VOL I SAMPLE# <br /> S <br /> ELINQUISHED BY/AFFILIATIO -) DATE TIME ACCEPTED BY/AFFILIATION DATE TIME ADDfTlONAL COMMENTS <br /> 4 9 <br /> �OL <br /> LI <br /> CLV 16722 Distribution White Original(with Data) Pink-Lab <br /> PKG750 Yellow BP Blue Consultant Field Staff <br />