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Show Field San; / v (flJVrI ;/f I I Chain of Custody Record Parametrlx, Inc. &808 Lake • Washington Blvd. Kirkland, Washington 98033-7350 • • 206-822-8880 Fax 206-889-8808 • , f4, ",pr.....M ......). rA'Lt-t", \\. Project Name: Samplers: :",: . I Project Number: 55- '7_'O;A If.? - ! .. - ,- ..,,- , -...._ J " of Container. and Matrix Sample Number - t, Preservatives "It fhra -tr K Recorder: tJ MeJ"('( L( Client: ()il- '1{J.ysl Lt7 Date I I I j """'- .. f U c I - C E /111 III :s 'P Q.I i= e ." C II II II :J ... 'i N III ... II II .t: II • Q. 0 '" :J: en 0 N Z ::J: 0 0 C U j ::J: ::J: jl?- ""J , r?- ) X ftI Z ,- ., :s:- o!! \ .. 0 X ;2- l' l>x 'I, z Px 9 ,). - - ')( lJ, y x-tt+ l( 9't . IIA 1(. '( 7 X i -x 1< c, )( }C If) ( " X ',", ' Total Conta V ,q ..., " 1<19'1 - - dccl Px 9+ O:l. fJX-t(i d.OD3 lJ'i- 'f7 ;)OOLI (JX- 91 'J005 6 ,,/)X CJ? PX'" 91- dOO? ro8 PY-9] - - - 7 -, 7 9:J- 7 97 7 7 CJ'"l911 "77 - - - - 'i? 1f - I> f( Day g - )< Month '7? q - i1) e 1 q q +- - - or .\; .,:,,/-... I II s: Px 9"+ ,A; - .. " - Year 971 97 g 7 7 CI':f 'g'" If &/7 « (/ 9:; -x (I q"? "'K II 9; Time \\ (0_ \eN\t.r-M.. I f II , . II . • I Chain of Custody Record (Please Print) I t Date: (I Rl"nqlshed,Br (Name) AeJr( J = /"\l t,l . \ Time: rR,elved By: (Name) Date: 1)!t;l, O?.f') fr, ( W'-f).f17 /I.r if ("1-1 . f"- /}-9/ /'j .' )tJ' - jjtiv - / - - Time: ;}/C17 -- r r -rr I'd ,'30 I Shipping Information ( 1-; : . Coole"': I r ,- ...... , .. " • • ....... a. _ ; ••• , : , 11 I. " Alrblllll: - . White Copy: laboratory , Yellow Copy: Return to Pararnetrlx Inc. ' Pink CoPY' Pararnetrlx Inc, I of - Coolers on this Alrblll . |
