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Chain-of-Custody Re ytic Instructions Page —of B G 0 n <br /> Send all results and invoices to: Field Log Book#(COC#) Release# LE-r0%`1 <br /> %/'1 <br /> j <br /> M. Heato�l , LLNL Acct. # l.� � '�/-/? Sampling Request# <br /> � -.� i { lease fill in and circle) <br /> `----Attn: ORAD Data Management Team L-633 Analytical Laboratory Name <br /> Lawrence Livermore National Laboratory Analytical Laboratory Log# <br /> P O. Box 808, Livermore,CA 94550 <br /> •. J <br /> or a <br /> # ); TaX Analysis &Turnaround Additional Instructions to Lab <br /> Also Fax copies to:. � k_._,ern e-. Fax# 4117_ .'�fll� Required 1 <br /> Project Name: <br /> Sampled By : ! 7� i� ' Sampler's Employer: ll-.)-4 �l `n N <br /> Sample Sample Matrix/Type 2 #of lip <br /> Grid/ <br /> Q � t\ <br /> Identification Date/Time Container/Type 3 Cont. Area rte_ `� ��' �(,' Relllat'iCS <br /> r 4 b?- /r -on/-t, -SG-/ ; <br /> e / ` ; i <br /> Signature Company Time D to 1. N=normal turnaround, F= I-week turnaround <br /> Relinquished by -� ^ iX30 ' ; R=24-hour turnaround,11=I fold do not analyze unless requested <br /> Received by %,�-, C7 ) /_�p�s 2. Sample Matrix Codes:See tilt on back of pink copy <br /> Relinquishe - /7r'3G 3. Container type codes: V=VOA Bottle,P=Plastic Bottle, <br /> Received b _ ((,, G=Glass Bottle,T=Brass Tubc, <br /> %� c 11= Bag,S=Stainless Steel Tube, <br /> O=Other(specify under remarks) <br /> Relinquished by <br /> Internal Use Only <br /> Received by C( <br /> Revision 3.3 White..Laboratory return to 01W) Pink:Sampler leaves with ORAD <br /> Attu.Data Mann ment Team 1 633 fellow:Analytical Lab A(W.ORAD Data Management Team 1.633 <br /> 29 Oct.93 ORADse, <br />