Laserfiche WebLink
I! <br /> ASSOCIATED LABORATORIES <br /> 806 North Batcmcr ■ Orange CA 92868 <br /> j Chain of Custody Record Phone (7I4) 771-6900 ■ Fax (714) 538-1209 <br /> —t r � <br /> Gompany;1/�0 p � ' Phone �` Q 2 3 � A L Job No �' ` ` Page of <br /> Project Manager L { Fax f9G- <br /> ���� �6 2- y'ZAnalysts Requested Test Instructions&Comments <br /> Project Name Project# <br /> Site Name <br /> and <br /> Address s TbC4:�log + <br /> Container <br /> Sample ID Lab ID Date Time Matrix Number/SizePres �Q <br /> umber/Size <br /> 2 f FU1rt! V- 17-C* fl,'In rf1 HoNFL 'ic �r <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> a <br /> 9 <br /> 10 <br /> 11 <br /> 12 <br /> 13 <br /> 1 1 <br /> 14 <br /> 15 <br /> Sample Receipt-To Be Filled By Laboratory Reiinquishe[�y, :, 1 Aetrnquished by Z Relinquished by 3 <br /> Sampler <br /> LAS <br /> Total Number of Containers Property Cooled Y/N/NA Signatures�^ Signature �n I Signature <br /> Custody Seals Y/N/NA Samples Inlact Y/N/NA Panted t�a)�ek Printed Name STT Panted Name <br /> Received in Good Condition Y/N Samples Accepted Y/N <br /> Date �,L15� Time`�` Date Tlme Date 7rme <br /> Turn Around Time Recerv�ed,�y6� (� Rec ved y Received By 3 <br /> Signature w�b`') 61 1� SI a Signature <br /> Ifs IYdr a� L) Rush ❑Same Day ❑48 hrs Printed NameP�C-tom lT7T Print d l Printed Name <br /> �� � 0 2 hrs ❑72 hrs <br /> Da Time Dat r T e �� Date Time <br />