Laserfiche WebLink
720 Olive Drive,Suite D <br /> Davis CA 95616 <br /> Lab 530 297 4800 .� <br /> ANALY77CAL LLC Fax 530 297 4803 Lab No.�- Page of <br /> Project Manager Phone No Z--] <br /> S o_6 _ o Chain-of-Custody Record and Analysis Request <br /> Company/Address �C z:- FAX No F- For Lab <br /> Uro — S3 0 �G a 4 7� Analysts Request Use only <br /> Project Number P O No Email Address m x r <br /> �df ElAs ❑ dor- ❑ether g w w w <br /> Project NarnelLucatton�C Sampler Signature, 2 _ S w m m <br /> n n <br /> 7 / /_ f� ` / Gl X tX K x ry n n <br /> G.( S I LK / CT W @ J O tl <br /> Container Method W 0 o W a a o w <br /> m m m L� m fn a µ ry E E E E <br /> Sampling (Type/Amount) Preserved Matnx F = _ cu (} n n a n a <br /> -- n n N <br /> 4 j o p C A q N r V tl rl <br /> �_ W od m u m Oi M m C d r[ aC <br /> Sample W <br /> E C? Z F X X ro N i7 �c' a au A a r r u u <br /> Designation Date Tlme n i z 3 m m w ° o o w M N Q ti <br /> Relinquished by o to Time Received by Remarks <br /> � 7 Y <br /> Reitnquts y _ <br /> Reisnquished by T Oates Time Rec*ivO by Laboratory �.r Bill to W <br /> c�- <br /> Distrebutron White Lab Yellow File Pink Onginator COC fh9{5100) <br />