Laserfiche WebLink
PH,ASF COM ITIF 11 <br /> Laboratories,Inc. <br /> Chain of Custody Form <br /> Teiwrf To: P <br /> Cg .lienL- —Project#- ------ Paeof <br /> ... .... <br /> Comments: <br /> Attn: <br /> Street Address: Project Code; P <br /> City,State,Zip,PUi. Saniple s): <br /> Phone Fax: <br /> Are them mks tests%"Lh holdlieg Limes less than <br /> S le Matrix 'e <br /> or equol if,48 Wars' <br /> Email Address-.'I& <br /> El Yes <br /> No <br /> subluittai.#: <br /> *Standard Turnaround m 15 workdays <br /> 0 <br /> En 0 0 3 Other Notes <br /> 7 <br /> "A <br /> v <br /> W 0 <br /> -A- <br /> z <br /> 4, <br /> xZ <br /> 7 <br /> Sample Disposal Special Reporting <br /> ❑ Same ❑OC ❑WIP E Raw Data <br /> as above Report DrIuM4 <br /> Waters on State Form? ❑ RLt.,.to Client ❑ Disposal by 1-b El Archive: M--th-= ____� � <br /> Client: -S Date Time 1. Rec vpd By Date Time <br /> ❑Yes No <br /> v <br /> Address: ....... <br /> ---——— ........ <br /> Ti <br /> 2. Rel.oquished By Date I -, 2./RecTime, <br /> 4 Z. Send Copy to Stale of '7­70� Zy' ate <br /> City w;>. <br /> S tj�te 'P 4CA? <br /> Attn- 3. Rc , <br /> -!L-quishW By <br /> Yes ❑No Date 3. Rucei,,t:d By Date Time <br /> _PO#: <br /> BCLaboratories,Inc.—410OAuras Ct.—Bakersfield,CA 93308—661.327 4911—Fax-661.327.1918—vww.bc1abs.com <br />