Laserfiche WebLink
<br />Chain of _ I . ~ ~-~ . 0 <br />~ Cus[ody Record ~ 3 ~ ~~ 3 <br />oe~.,z, e,o, <br />~,'vuanterra <br />Client <br />Glz. eN~ K.. rte Projeq Mgaager <br />~ zeE~ Dale <br />1 Chain of Custody Numb 115 C <br />Address <br />I SLI L, 73rltArZl/airJ # ZCt7 Talephono Number (Area Code)/Fax Number <br />n" ~O- ~V lab umb r <br />Pege of <br />City <br />. <br />L State <br />`~ Zip Code <br />~D <br />I Z Sife Con cl La6 Contact An <br />mo alys <br />res is (A <br />ace ttac <br />is n h lis <br />estl t I7 <br />ed <br />NG ~[N~~ <br />~ I <br />Protect Name <br />s~vc'>;2 /Zo,gtry INLr ~fPnrrf CarderANeyDlll Number <br />Speciallnstruc~ions/ <br />ConlratVPurchase Order/Ouofe No. <br />Matrix Contains/S 8 <br />Preservatives <br /> <br />~ ~ <br />~ Conditions of Receipt <br />Sample 1. D. No. antl Descrip(ion <br />(Containers ror each sample may De combined on one line) Dale Time pp <br />S <br />YYYY <br />a <br />h ~ <br />j a <br />= o <br />2 <br />2 o <br />2` ~o <br />N ? ~ <br /> <br />DO ~ ~ <br />- Z S I vu • 2 ~( <br /> /u <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />Po mle nazarp roennncauon sample u~sposal <br />(A lee may De assessed 11 samples ere relainetl <br />Non-Haza,d ^ Flammable ^ Skin Irritant ^ Poison B ^ Unknown ^ Return To Client ^ Disposal By Leb ^ Archive For _ Months longer Ihan J months) <br />W <br />A <br />DISTRIBUTION: WNITE ~ Slays with the Semplb. CANARY- Returned to Clien( wah fleport; PINK -Field Copy <br />