Laserfiche WebLink
C BA <br /> 111 I L IIS 49 <br /> 8 2 Pe ium CA 497 <br /> ohe^e 170 r 24s x cror»ss.00es SAMPLE CHAIN OF CUSTODY 1 WORK ORDER <br /> Clients Name M p I b <br /> Address F C Zoo <br /> Phone I <br /> City State Zip 5 1161-9-!; G <br /> Client's or Representatives Signature <br /> (signature authorizes the work and terms i bel ) <br /> All samples remain the property of the client who is responsible for disposal A disposal fee may be imposed If client falls <br /> to pick up samples <br /> PROJ No PROJE;NAMI <br /> 1sggy or Af <br /> SAMP Signature) ` REMARKS <br /> NO <br /> A OF LAB <br /> CON- USE ONLYI <br /> $TAN DATE TIME STATION LOCATION TAINERSLAB NO <br /> l <br /> l <br /> I <br /> i <br /> Relinquished by (Signature) DATE TIME Received by (Signature) General Remarks <br /> S'q �✓rYl Cgs« 4r ,'sem! <br /> r :::I,, <br /> elinfi#egby (Sig &lure) A TIME Received by (Signature) <br /> ii <br /> Rerhlqurshedby(Srgrtature) D TE I TIME Reeervatl6y($rgrrafure) <br /> r r <br /> { CLIENT COPY <br />