Laserfiche WebLink
M awl r <br />COMPLICHEMLA BORA TORIES <br />WESTERN DIVISION <br />.r tl�l r M M M I~ <br />Chain of Custody Record CW ID: ----- <br />Date ��2 Page i - Ot . -� <br />PROJECT NAME m5,S4dfon- ero/GZ <br />GC <br />GC/MS <br />INORGAIC6 <br />OT <br />VE <br />Ir <br />Q <br />zo <br />m <br />REMARKS <br />PROJECT NO. W x('o2arlfr,(.r <br />-� <br />= <br />a <br />r— <br />_ <br />u <br />Xopo <br />w <br />i— <br />M <br />O <br />_, <br />O <br />`D <br />000 <br />O <br />`D <br />ID <br />O <br />co <br />O <br />`D <br />to <br />m <br />U <br />a- <br />® <br />O <br />coN <br />N <br />CD <br />o <br />oGo No <br />N <br />(D <br />o <br />°° <br />� <br />N <br />co <br />--I <br />U <br />J <br />U <br />Q <br />I— <br />w <br />2 <br />v <br />_Ir <br />U <br />t— <br />W <br />Q <br />Q <br />h <br />\ <br />PROJECT CONTACT: 54ye Alueiflei/l <br />SAMPLERS (SI N TUR ) <br />SAMPLERS y/ 7'/ <br />PRINTED NAME ��D ��/' <br />SAMPLE NO. DATE <br />TIME LOCATION <br />Ale S - / <br />N- moi/s pAc <br />D <br />D- <br />D1T1Ill --- <br />_-SAAl <br />RE <br />1 <br />GE <br />RELINQUI HE BY DATE RECEIVED BY <br />y <br />DATE <br />y1 <br />RELINQUISHED BY <br />Signature (!/7turMETHOD <br />M�NtN S Z <br />DATE <br />Y,��/„ <br />RECEIVED BY <br />DATE <br />TOTAL NUMBER <br />OF CONTAINERS <br />' Signature <br />SinaZ,6e,�d�,�/ MENET `�� <br />OF SHIPMENT <br />Q'r'1� �y <br />L� <br />OR STORAGE REQUIREMENTS <br />_ <br />TIME <br />Printed Name Printed Name <br />.(' YdI' :ins G �'t�wf3>- <br />TIME <br />1b45A <br />_ <br />Printed Name <br />cuEMw� _ <br />TIME <br />t�D'n <br />Print d Name <br />or, ly <br />ME <br />Company Company <br />Company <br />RELINQUISHED BY DAT CEIVED BY <br />DATE <br />RELINQUISHED BY <br />e�DATE <br />B/ <br />� <br />REC'D BY (LABORATORY) <br />Sign�rae4N GIL6ERT <br />DATE <br />��a7 <br />l <br />TIME <br />Signature Si natu <br />g g <br />\ <br />Sign <br />g <br />— <br />Printed N e TIME Printed Na a <br />Co pany Company <br />TIME <br />rinted Name — <br />Company <br />IME <br />I <br />Pn <br />OMEST LAb <br />Company <br />600W-Nonh Market Boulevard ° 5acranlento, (;A 9')8:i4 • 1'n0rle (41h) 923 t►ti4U R( inSF( RnSINFSS FORMS (916)flI <br />