Laserfiche WebLink
CHAIN OF CUSTODY RECORD <br /> HC luy tJurnnr�i <br /> Client name r �y Protect or POI <br /> Analysos requ000l <br /> Address � Phone I \ <br /> City,Slate,Zip Report Itenlion ,Ga <br /> �� ca <br /> a°J c�ac� <br /> Lab ' e` sa'tlplea°y �U <br /> Sample Dale Time See key Number <br /> number sampled sampled below of �tivpa <br /> Sample description containers <br /> Remarks <br /> IBJ <br /> op <br /> Signature Print Name Company Dale Time <br /> Relinquished by <br /> Recehred by <br /> Relinquished by <br /> Received aEl �f �21L <br /> ( Be �1 + q <br /> r <br /> i RN A by <br /> Received by laboratory <br /> BROWN AND CALDWELL LABORATORIES Note: <br /> A1255 Pavall Sheet.Emeryville,CA 941308 1415)428-2300 Samples are discarded 30 days ah or results are reported unless other arrangamcnls are made <br /> 373 South Fair Oaks Avenue,Pasadena,CA 91105 (818)795.7553 Hazardous aamptes will be relu,ned to client or disposed of at them exponse <br />