Laserfiche WebLink
SunStar Chain of Custody Record COLaboratories, Inc. 0 <br /> PROVIn1NO QUALITY ANALYTICAL SEHv1CLti NATIONWME <br /> 25712 Commercentre Drive, Lake Forest. CA 92630 <br /> 949-297-5020 <br /> Client: Lor� Date: 7�ia l a 3 Page: I of <br /> Address:-. girl ' le-. SIT Project me: t•4.,k1CWAA'_ &Z&% <br /> Phone: Fax: Collector: kw Client Project#: <br /> Project Manager: JLW 4. Batch #: 4 2 31 1 EDF#: <br /> C N <br /> SO � <br /> o 0 N m v <br /> } CIA q G <br /> x* x m <br /> Q = c <br /> L1 } x x LO U ~o o <br /> a � D � � � � w o � o <br /> m + m m � � g r• U � <br /> Date Sample Container ry u) � � `o 0r m <br /> � CV CY GO OD a v o a o CD ° <br /> Sample I❑ Sampled Time Type Type oo wco OD m fl CommentsPreservative <br /> I— <br /> r -�- v <br /> 0 s- <br /> p - O <br /> s -J.0 s <br /> 7 1 VIO <br /> � Ur <br /> 0 5Ja 90 <br /> 1 X- iJ Y <br /> r� �-ISr <br /> r 3 3 -;_U IUM <br /> r'1 - )_ r) <br /> 1- w <br /> Relinqu+ d y: (signature) Date I Time Regei 6y: (signature) Date 1 Time Total#of containers Motes <br /> 24 <br /> Ls -- Chain of Custody seal R Is d by: {signature} Date 1 Time Received by: (signature) Date 1 Time Seals intactt/NA <br /> 'NA <br /> 5'oc j fw•-�3 <br /> - ,O 20 4-j 1�[7t7 ,GAT)GLS Received good oonditionlcold <br /> Relinquished by: {signature} Date I me Recei ed b : (s nature) Date 1 Time �{� r <br /> V` Turnaround time: 1 rr� ' CV <br /> Sample disposal Instruclions: Disposal @$2.00 each Return to client Pickup <br />