Laserfiche WebLink
<br />I <br />I <br />yyR <br />' <br />CHAIN OF CUSTODY RECORD 0 2979 East Center Street Conneaut, OH 44030 Tel: (440) 224-2261 Fax: (440) 224-2808 <br />01101 Howard Drive Deer Park <br />4.7 =ry•'c ?? ®?"?? America In <br />TX 77536 T <br />l <br />2 <br /> <br />, <br />: ( <br />e <br />81)930-1919 Fax: (281)479.4969 <br />c. <br />0 4665 Paris Street, Suite B-200 Denver, CO 80239 Tel: -(303)373 <br />-4772 Fax: (303) 373-4791 <br />:11501 -A East Patapsco Avenue Baltimore, MD 21226 Tel: (410) 355.1958 Fax: (410) 355-1965 0 2804 Hackathorne Lane Gillette, WY 82716 Tel: (307)' 682-7917 Fax: (307) 682-7951 <br />1- ro-B-ox 850 <br />- <br />Sophia, WV 26921 Tel: (304) 255-0422 Fax: (304) 255-0417 O Route 2, Box 162A Middlesboro, KY 40966 Tel: (606) 248-4205 Fax: (606).248-0044 <br />J; 216 Oxmoor Circle Birmingham, AL 35209 Tel: (205) 942-3120 Fax: (205) 942-0914 O 15550 N. Lombard - Terminal 5 Portland <br />OR 97203 Tel: (503) 265-5905 F <br />503 <br />28 <br />, <br />ax: ( <br />) <br />5-5086 <br />;;15793 MacCorkle Avenue SE Charleston, WV 25304 Tel: (304) 925-6631 Fax: (304) 925-8877 016130 Van Drunen Road South Holland, IL 60473 Tel: (708) 331-2900 Fax: (708) 333-3060 <br /> <br /> ;GS Reference <br />1 : O <br />PAGE <br />( Otd'fc CT <br />PHO ^ -, ( OF <br />?- <br />NE NO <br />.(4;b86f -2S"YQ <br />i .- . <br />1' 110,1L T. SITE/PWSID# : <br />N o <br />SAMPLE Reservarnee <br />Uled <br />i <br />..._.._........_ <br />;i 4aEt OI I'S TO <br />t <br />+ (_ <br />' <br />Q <br />C <br />Anal" <br />Require <br />, <br />? <br />{ <br />FAX NO <br />:( /-0 8L ¢ 21 G g <br />t1s??'h' ??42 <br />? O <br />Y G_ <br />COMP s <br />. <br />.. <br />...._._.._.. <br />ltdVc'gC: <br />TO: QUOTE #: <br />7 A GRAB <br />B <br />P.O. NUMBER: N <br />; <br />s•ama ?; ;amia tsar E <br />LAB Rf SAMPLE IDENTIFICATION DATE TIME MATRIX S <br />i 1...-._. _.....-- - N REMARKS <br /> <br /> 4 ' <br /> <br /> <br /> <br />{ <br /> <br /> <br /> <br />I <br />A"Xii-u .. aam& M <br />KW <br /> <br />4 <br />fished E :( Date Time Received By: Shipping Carrier: U? Samples Received Cold? (Circle YE NO <br />I ! <br />_ ' <br />)q (?.?g <br />MOD <br />Shipping Ticket No:. <br />Temperature°C: ?.• <br />2 <br /> <br />' -1PL <br />6 <br />Reync.lished <br />By: (2) Date Time Received By: Special Deliverable Requirements: Chg(, of Custody Seal: (Circle) <br /> <br /> INTACT BROKEN ABSENT <br />IL li,xi iishec:' eiy: (3) Date Time Received By: Requested Tumaround Time and Spe .ial Igatr'uctions: <br /> <br />?.a rr,