Laserfiche WebLink
Laboratories,Inc. Chain of Custody Form 11I.C.11.12LICYTE ID., <br /> tz r ,Tor <br /> ° 6 6 <br /> Client: j c;,.. A -- Project#: Pae of .3 <br /> Atte: ' ,� ,�` !, Fr.� Project Name:A' E Comments <br /> ` P <br /> Street Address:,,--'h!-.-9, !"Global IB#: _ n 1. .F,,.;.; s . a , .: _, - _ ? <br /> 3. i '. r r <br /> f <br /> 1Saner(s):Cl State,Zip:' ct <br /> Plt4)S4C:'✓ @ a Fax. n t <br /> Email AQl(1rE$5..%4 R771pyE Nl trlX [ ire tbsrc�n�or equil to 49 hours7n es 1r.5_ har, <br /> S a <br /> Work Order#: T.. ,. s� �� �� � ❑vas El No <br /> ...m-. <br /> Standard Turnaround=10 work days <br /> 6 3 Other <br /> Notes <br /> ,""l� F.s:'`Nc c' �-r,"r't�:bw-�: '•w.?' d t,Y °:, 3 - <br /> 7� i <br /> 3 � <br /> U, I III <br /> 8.a s' J I <br /> l ,t.-' 3t .f <br /> a 2 bAF.> �s MIF .A t <br /> n { <br /> t ❑ <br /> Report Drinking Sample Disposal Special Reporting <br /> Same as above <br /> Waters on State Totma't ❑ Return to Client Aiz]sn a!hy'.ah ❑ Archive: �4nnthc CC ❑ EDF Raw Data <br /> Client: a r + t a f, 1 Relingn'Shed J Date Time 1. Rec lved By Date Time <br /> i ❑Yes ( No f <br /> ' '.+. s s <br /> Address: `t - fI <br /> ''��, °f <br /> Send Copy to State of 2. Relingriitshed By Date Time 2. Received Try Date Time <br /> City Stage r �Sp. CAS I U � 12��[�t { <br /> s, ' bb <br /> Attn. ❑Yes P`No 3. Relinquished By Date Time 3. Received by Date Time <br /> PO# _..w,....._...w <br /> BC Laboratories,Inc.-4100 Atlas Ct.-Bakersfield,CA 93308-661.327.4911-]Fag:661.327.1918-www.bclabs.com <br /> is 0 1 . 0 <br />