Laserfiche WebLink
U., n CHAIN OF CUSTODY <br /> Acctftest Job #: D12928 <br /> <br />4036 Youngfield St.. Wheat Ridge, CO 80033 <br />® ??UTE <br />ST <br />Accutest Quote 1f: <br />. <br />303-425-6021 FAX: 303-425-6854 AMS P.O. # <br /> Project No_: <br />Client Information Subcontract Laboratory Information Analytical Information - <br />Name <br />Accutest Mountain States AMS Name <br />Hazen (Radiological) <br />o <br />Address <br />4036 Youngfield St. Address <br />4601 Indiana Street <br />m <br />city state Zip <br />wheat Ridge, Co 80033 city state Zip <br />Golden CO 80403 s"i <br /> <br />a. <br /> <br />R <br />Send Report to: Tiffany Pham <br />Any questions contact Amanda Kissel[ Contact: <br />Sample Management N <br />o + <br />Phone/FasM (303) 425-6021; 303 25-6854 Phone: 303 279-4501 a - <br /> Collection Preservation G <br />L a <br />N <br /> <br />Field ID / Point of Collection <br />Data <br />-rime <br />Matrix COI <br />bottles <br />J <br />= <br />d <br /> <br />z <br />il <br /> <br />= <br />l N <br /> <br />i m <br /> <br />z ` <br /> <br />U O <br />` <br />0 <br /> <br />Comments <br />D112928 -1 4/28/10 12:00 PM Soil x X <br />-2 4128110 12:00 PM Soil x X <br />3 4128110 12:00 PM Soil X X <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />Turnaround li forma0on -- ?> Dat a Deliver able Inf orm atio n Comments ! Remarks <br />FX-l 1 •2 Business Day Rush Approved By: <br />? Other (Days) <br />?.VS h e r,.,s / r^ <br />6a,a ss d 6 a- $TD Tu r.. , <br />10 Day Turnaround Hardcopy, RUSH Is FAX Data unless previously <br />approved. ? Commercial "A" Ej PoF <br />[-] Commercial "B" a Compact Disk Deliverable <br />EJ Commercial'BW El Electronic Delivery: <br />0 Reduced Tier 1 p State Forms <br />? Full Tier 1 El Other (Specify) Need back -1008 for SPLP. <br />Please call Nat or Jeremy @ <br />Accutest when samples are <br />crushed and ready for <br />pickup. <br />Sample Cust must be documented below each time samples change possession, including courier delivery. For Subcontract Laborartory Use Only <br /> <br /> <br /> <br />` ?t ^: Z? la <br /> <br /> <br />?' 1 c 7:? A - <br /> <br /> <br />I?WYIF. 1 <br />MW*T <br /> <br />¢.,3 <br /> <br />ea pets: <br />Yas ? No ? NA ? <br />2 nq 2 c y: 2 mel 1 reserv? ere applicable: <br />e np <br />3 me: ctw y: <br />3 a me: <br />3 n ice <br />Temperature °C ? <br />D12928: Chain of Custody <br />Page 4 of 7 <br /> <br />®® 13 of 33 <br />MACCUTEST. <br />D12928 Laboratories