Laserfiche WebLink
�0� R C � Laboratories, Lab Report# T I ) 12 O' _ <br /> alb Inc. <br /> Regulator' Oyes )No CC: Mes 0 No <br /> 140$ Kansas Avenue Phone: (209) 572-0900 <br /> Modesto, CA 95351 Fax: (209) 572-0916 Regulator: ,k/ , <br /> - - Phone: ( } <br /> Client: �- � CHAIN OF CUSTODY Fax: ( } <br /> Address: .32-33 13 EDF ❑EDT Original To: <br /> City - Zip Z7 FIELD LOGS C.0 To: <br /> Project ID �° r Lab Use Only <br /> (Print Name) f2` <br /> Sampled By `/� <br /> (Signature) l If, ° 'v a <br /> Container <br /> Sample type c <br /> Sample ZD z Lab ID# c, <br /> Date Time Grab Comp jkri" T'pe Site <br /> Aemar <br /> i <br /> Remarks <br /> 1 by Relinquished Relin 5nature) D to Time <br /> 9 ( Received by(Signature) r j➢ate Time <br /> Relinquished by(Signature) Date Time Received h. (Signa tore) Dale Time <br /> Preservative: Matrix <br /> ro 40C IHCL Na0H Na2S203 -HNO, 0-H SO 4 -Ocher Drinking Water Waste Water CMHazardous Waste (Water) SoillSolid <br /> Mileage <br /> Bailer's _ 55 Gallon Drums Pcmtip Truck Time <br /> 13h <br /> Turmirouhd Time ❑Standard ❑silver Ru5h ❑Guid Rush ❑Platinum Rush ❑Ocher Approved By: <br />