Laserfiche WebLink
<br />CORE LABORATORIES, INC. <br />No. 48760 <br />CHAIN OF CUSTODY REC01~- <br />CUSTOMER INFORMATION " „~ ~ ~ 'gPp ~ Q r h~ ' 0 .~ _`c:F ; .,~~~, •rj <br />^ <br />COMPANY. ~ <br />SEND REPORT ro: ~ PROJECT NAMEMUMBER <br />BILLING INFORMATION -..1 7 <br />ADDRE$$ O ~' „ BILL T0: ~ h` <br />• ~ Sa ADDRESS : ~ LA <br />NO. <br />B J <br />O <br />B <br /> ~ ~ / <br />/ <br />y <br />~ <br />~ <br />~ <br />PHONE ! t a ~~ _ r~ l <br />! l <br />d <br />`l <br />e PHONE: ~ I~ <br />r ~ v <br />w <br />fA ~ <br />L~ <br />~ <br />~~~ ~ UJ FA%: PO NO.. ~:~ .- N <br />• LE NO 54MPLE DESQ9IPTION SpA LE SAA'VLE <br />aIM6; SAh1PLE <br />., hwrnix CONTAINEfl TYPE <br /> <br />~ RESER <br />,`~ <br />'; <br />REMARKS ! PRECAU~IQ <br /> a a '~ Z4 . t tso~ ~ ~ ~ I - s <br /> : , <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> .~~ s. 7~ <br /> <br />SAMPL <br />~ ,- <br />- <br />`~,C2~ <br />$HIPMENi METHOD <br />AIRBILL NO: ' <br />4z 3 ~f <br />1 <br />REQUIRED TURNAROUND.' i I SAME DAY I 24 HOURS ^ IB HOURS C ~ 72 HOURS 115 DAYS ^ 10 DAYS ^ ROUTINE OTHER <br />I ELINOUISHED BP DA EIINOU15HEBBY: ~ ^ 'C ' is r: "- `. ~ w' . f" DATE 3dRELIN ISHED BY: ~ DATE <br />IG , <br />ec G GL ~ y{I SIGNATURE' SIGNATURE: <br />P I TF~A~ NV~ <br />1. RECEIVED BY: .. E ~ <br />ATU ~I~ 3~ <br />DAT <br />~~ PRINTED NAMFICOMPANY <br /> <br />~, SIGNATURE: <br />" TIME <br />DATE PRINTED NAMEICOtAPANY: <br />.. 91< : ~~ <br />SIGNATURE: , <br />^ TIME <br />DATE <br />PRINT NAMEICOMPANY~ IME PRINTED NAME/COMPANY: TIME PRINTED NAMEICOMPANY TIME <br />• RUSH TURNAROUND MAY REQUIRE SU .C E <br />^ Ambim, fahlnrnn Aurora IOnnvn 1, CelDnis ^ Cnpr. WYDmmp <br />1750 E Gen, Auuv Wry 10107E Ba Mny Ouve 110 Wrn In Even <br />Ar4hnm. CalADmn 91605 Auran. GnI00a080014 4,Pn, Wypminp 91601 <br />1/11197/1094 130]1 /51 1190 170711796111 <br />1~001404d6/7 16001971 I61J IB001666~OID6 <br />^ Cerlm Chrlnl, Tnn <br />V 7] NDnM1 PnElr ItlnnE Ornr <br />Carom Chary, Tnn 78409 <br />16171789~76/J <br />IB00164887IB <br />ORIGINAL <br />^ Neunan, Tun ^ lob Chnhn laurwnn <br />9710 Manlry Bony 7fi/9 Be91ir Pnrhwny <br />Haunpn,TUn11079 SulDnur. LDWnum 10667 <br />17171917 9116 IJ I BI 697 X976 <br />190017J4dfi13 180017694976 <br />^ Lanp 9,nch, Gliluw <br />]100 [nervy Avmun <br />loop Bnrn. UhlDmu 90907 <br />17101 5 9 9 810 1 <br />1800101/JiJ7 <br />