Laserfiche WebLink
4-� PIKrMNE,�TE e� ALiANA IS f GESS"` �-`tfi I Ii <br /> T <br /> CONCORD, CA 94520 ,, , �• +ror { t <br /> Cry i ' ti I <br /> 510 685.7852 <br /> INVIIIONMINIAL , •~ w <br /> LAIOIAl0111f, INC 1800 423-7143 <br /> )mpany Name Phone N ❑ <br /> Fax+A tu ❑ ❑ ❑ <br /> Site location ❑ ❑ ❑ a $ <br /> lmpany Address ` ❑ <br /> G 0r+Cnnc� 5-�OoN E3 V) ❑ a <br /> manager Gllent Pralect ID (N)p ZQ'3 O l 2 I ID <br /> w N m 2 0 0 ti m <br /> aJect 9 NAME (30 ❑ ❑ z z ❑ , ❑ ❑ ❑ <br /> € o ❑ � o ❑ ❑ s <br /> Sampler Name(Print) a a & ❑ © ❑ ❑ m o <br /> attest that the proper held sampling , a A i3e rocedures ware used during the collection�rQ M 1ec7(' +�F-f� ❑ o ¢ © a o ❑13 <br /> f these sam les �S oMatrixpeserved Sampling _ v o o ❑ ❑ <br /> QTEL ❑ v r ❑ ❑ ❑ p <br /> Field LU " cc i I # <br /> Lab # 5 Q 4 a a a a Q N <br /> Sampleuse � � � � � - <br /> 1D (Lab Y) $ < °��` a = L a m z b lL 8 �iI iI uaJ <br /> :—a,,1� <br /> w - � ,3 <br /> rnvJ <br /> S � r <br /> TAT Special Handling SPECIAL DETECTION LIMITS <br /> 00 CUA <br /> Priority(24 hr) <br /> ❑ GTEL Contact <br /> Expedlied(48 hr) ❑ OuolelCordrect N Storage Location <br /> 7 Business Days Contirrnalton I SPECIAL REPORTINQ REQUIREMENTS h Use <br /> Other PO <br /> Business Dae ❑ <br /> QA 1 DG LEVEL <br /> Work Order N <br /> BLUE❑ CLP❑ OTHE FAX is Time Received by <br /> Rell ish by ampler <br /> Dakii Time Received by <br /> Relinquished b <br /> CUSTODY Date Time Received by Laboratory <br /> RECORD Relinquished by' { <br /> Waybill# <br />