Laserfiche WebLink
KENNED .,(S CONSULTANTS * 0.200 New Sine Rd #115,Bakersfield CA 93309 L35190 Neil Road 6300 1502 <br /> ❑530 South 336th Sl Federal Wry WA 98003 }336 Bradshaw Rd, 0140 Sacrennnlo, CA 85827 <br /> SAMPLE CHAIN-OF CUSTODY ANAL YSI REOUgT E) 17310 Red Fill Ave,6220 Irvine, CA 92714 0 303 Second St,San Francisco, CA 94107 <br /> ❑ 2191 East Bayshore Rd, #200,Palo Alto, CA 94303 0 1000 Hill Rd #200 Ventura, CA 83003 <br /> d <br /> `` <br /> POSSIBLE:HAZARDS VIA A%e 5e I- � ' `` <br /> n` s (6) <br /> !� ANALYSES REQUESTED <br /> Oats 3— — y Report To �e kl� (Mc K t n tl PV Lab Destination A n t-A b <br /> Source of Samples I our, Company � �� 43 Q Address Z � ST a <br /> Sampler NameL auK Address 'AL r I S (— <br /> U_, <br /> Phone _5b- "�ZS <br /> � Phone <br /> Project No 92ZS H o �b Phone NO '3Z t i A Carrier/Way Bill No <br /> UI ' <br /> X11 it1 COLLECTION 12) (3} 441 Turn- CommentlCondltions - <br /> Lab ID No. Client ID No, Date Time TYPO Depth Comp. Pres around {Container type,container number.stoj <br /> gY ~ 11 D 6L.J m be,- <br /> on--e- <br /> e/ <br /> Un I de r ( S JLA el I C Uk <br /> 4-v bae a n 4 a 150 <br /> 1e a5 -�c•x �Y � y�S�t Ids <br /> Pl-ea p <br /> 11) Write only one sample number In each space <br /> (21 Specify type of sample(@) Water(W) Solid IS) or Indicate type e <br /> 131 Mark each sample which should be composited In Laboratory as follows Place an"A" In box for each sample that should be coinposlted into one sample use sequential letter for additional groups <br /> 14) Preservation of sample <br /> 15) Write each analyses requested across top Place an"X"in appropriate column to indicate type of analysis needed for each sample <br /> SAMPLE RELINQUISHED BY SAMPLE RECEIVED BY <br /> Print Name ignature Company Oats Time Print Nance Signal ; Cortrpany Data Time <br /> LOU !Se UAL-t K 3"10 Ido , -2 r <br /> tW6a1t:rl9ioDY2 FRM oowes.ee <br />