Laserfiche WebLink
Client E LC t_0-L <br /> Calfforrl C� SAMPLE CHAIN OF CUSTODY RECORD Address 'it 4 V s 5Pc CA <br /> tModesto, <br /> Water Labs (please print) Phone Ido.( l E S's0795 Pro;. Mgr!Contact I. A Lw ARA w A PP 0 Box 4249 Ship samples to Pink Field Copy <br /> CA 95352 1430 Carpenter LaneWhite and Yellow To Laboratory with Samples <br /> (209) 527 4050 Modesto, CA 95351 Record 2 of Z Yellow Return to Client <br /> I <br /> PROJECTISITE NAME ANALYSIS REQUESTED <br /> LC5-'D( C Aoo�-R Y <br /> PROJECTlCONTRACTlPO NO L; <br /> PC P ;� <br /> It <br /> I NAME OF SAMPLER REMARKSISPECIAL INSTRUCTIONS <br /> Y� <br /> i LAB USE ONLY SAMPLE a m NUMBER <br /> I a OF <br /> � <br /> LAB I D I D DATE TIME O rr CON <br /> O O TAINERS <br /> 2.00 >LC PSC <<Uv-3 OOZ!D GN }ticr �tc�ST <br /> a <br /> C5U1lS <br /> I <br /> I <br /> RELI UISHED BY 1(GN) DATElrIME RECEIVED BY SIGN DATEITIME ., R CEI1tED FOR LABORATORY <br /> BY{SILNPC L ti DATEITIME <br /> f� <br /> RECEIVED <br /> COLD AND INTACT OTHER PRESERVATIVE DYE S NO <br /> ©OTHER <br /> TURN AROUND TIME <br /> I <br /> SHIPPED ❑FED X ❑UPS ❑OTHER SHIPPIN ER NO 024 Hr 02 Day Day 010 Day <br />