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i <br /> 1 <br /> ' T 73�- I�, S]4 U, 7 U"'+i =7 Ze,�. .. ,.,.-.. ";k- <br /> 7, S" a _E, <br /> WESTOt2 Analytics Use oR,v Custody Transfer Record/Lab Work Request Ulu <br /> 9 <br /> 9 po5 Refri erator# 5,) SSl WESTON Analytics <br /> Use Only <br /> f11T a Container <br /> Client -- 0.t'ta S l � �� 7� Vp, Y6, 1 Samples Were: <br /> Volume orsL raFSr{to c —Oj_Or t 1 Shipped <br /> an <br /> Work Order aw <br /> Date Recd. 916 90 Date Due :::::::n0 Preservative prat —NOTES: - <br /> Pic <br /> RF1k Contact -CA CsfrF_e6u fGr, _ ANALYSES �` EPN ,A to NA41 UT� GH r tai 6D8 <br /> Client ConteetlPhone— REQUESTED lcF 2AmWeNOTES: or Chilled <br /> AQ Only Client(D1Description Matrix Date <br /> � <br /> Cole ed 3 Received Broken! <br /> — V Leaning(improperly <br /> Sealed) <br /> NOTES: <br /> DC' v 4 Properly Preserved u <br /> 3 _ M1TOT N <br /> ES: <br /> k X 5 Received Within <br /> 00R 'gg V k x Holdingrimes <br /> 009 S [ Lai ?C X �}'� N <br /> D ES; <br /> COC Tape Was: <br /> 1 Present on Outer <br /> Package Y <br /> - 2 Unbroken on Outer <br /> Package Y N <br /> 3 Present on Sample <br /> Yin W-1OS•Drum Solids X•other Spe: Y N <br /> 1a11nilruGtions: f C �R Sler ok,5l rre d, b 6 r�c o.Pas r fccr 4 Unbroken on Sample <br /> S•SolSolt 0-011 OL-Drum Liquids NOTES: Y N A114SE•Sediment A-Air F-Fish *� — ACsisrt.D�� t_AI? ��r <br /> SO•Solid'1, YA•Wipe L- EPITCLP Leechole <br /> Item/Reason elan u 1b eceived b pate Time ftemlReason Relinquished b Received b Date Time COC Record Was: <br /> s li J 1 Present Upon Receipt <br /> r 60 of SamplesQ N <br /> IA,3A-6A' S L c•=� .d /6a0 <br /> a'i�}rFi $TF Discrepancies Between <br /> Sample Labels and CO <br /> Record? Y <br /> NOTES: <br /> I <br /> RFW 2i-2i-o011A-12!88 7-115 <br /> i <br /> ® 00 3005 <br /> _ i <br />