Laserfiche WebLink
CHAIN OF CUSTODY RECORD BC Log Number } ' <br /> Client name Project or PO# Analyses required <br /> Address23 1S -' �� Phone# <br /> 7/ i IGT, a <br /> City,StaI Zip Report ttention <br /> �c� Oq �5r`p�ly �V_e" V41 sneY' <br /> Lab Type, Sampled by.q Number <br /> Sample Date Time See key ' � of <br /> number sampled sampled below Sample description containers /,. �gq Remarks <br /> -7 ccn 'lQ -7 -3 3 5L' l -L rn w <br /> 4A-6 ��27 11' 3U C��J >r Ller f4TA—� 3 3 <br /> 2 27 12 15 A! -Z 3 <br /> -1 14Dk 3'•G)O �i V W r AT12- 1 3 3 <br /> A"-5 t 2� �5�� // r A`i K 3 3 <br /> 1D"30 tJ 3 3 <br /> A-rR 3 ! zss gy 12:15 7 3 3 3 <br /> Signature Print Name Company pate Time <br /> 7: <br /> Relinquished by /Y1 nukm J _12 gq <br /> Received by _ / l� ' j > <br /> Relinquished by <br /> Received by <br /> Relinquished by <br /> Received by Laboratory <br /> ,B�RfOWN AND CALDWELL LABORATORIES Note: <br /> pQ 1255?dwell Street,Emeryville,CA 94608 (415)428-2300 Samples are discarded 30 days after results are reported unless other arrangements are made. <br /> Hazardous samples will be returned to client or disposed of at client expense. <br /> ❑ 373 South Fair Oaks Avenue,Pasadena.CA 91105 (818)795-7553 <br /> ❑ 1200 Pacifico Avenue,Anaheim,CA 92805 'KEY: AO—Aqueous NA—Nonaqueous SL--Sludge GW—Groundwater SO—Soil OT—Other PE—Petroleum <br />