Laserfiche WebLink
California Department of Toxic Substance Control <br />Environmental Chemistry Laboratory <br />700 Heinz Street, Suite 150, Berkeley, CA 94710 <br />*hone: (510) 540-3610 Fax: (510) 510-3615 <br />SAMPLE RECEIPT <br />Printed on: January 19, 2007 <br />Authorization No.: 07EC0150 <br />ECL No. Coll No. <br />AQ00950 <br />REI <br />AQ00951 <br />RH2 <br />AQ40952 <br />R113 <br />AQ60953 <br />RH4 <br />AQ00954 <br />RH5 <br />AQ00955 <br />RH6 <br />AQ00956 <br />RH7 <br />AQ00957 <br />RH8 <br />AQ00958 <br />R119 <br />AQ00959 <br />RH10 <br />Custody Seals <br />Seal Location <br />Sample Condition <br />Action Taken <br />Present <br />Around The Lid <br />Acceptable <br />None <br />Present <br />Over Lid <br />Acceptable <br />None <br />Present <br />Over Lid <br />Acceptable <br />None <br />Present <br />Over Lid <br />Acceptable <br />None <br />Present <br />Over Lid <br />Acceptable <br />None <br />Present <br />Over Lid <br />Acceptable <br />None <br />Present <br />Over Lid <br />Acceptable <br />None <br />Present <br />Over Lid <br />Acceptable <br />None <br />Present <br />Over Lid <br />Acceptable <br />None <br />Present <br />Over Lid <br />Acceptable <br />None <br />Sample(s)processed by:Gt1�c/� Signature: Cum,,", ' <br />Date: <br />Supervisor's approval (if any action taken): Date: <br />Page 1 of 1 <br />