13.01.2013 Views

Dames & Moore, 1999 - USDA Forest Service

Dames & Moore, 1999 - USDA Forest Service

Dames & Moore, 1999 - USDA Forest Service

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

Chain of Custody Record 5<br />

Parametrlx, Inc. . 6808 Lake Washington Blvd. . Klrkland, Washington - 98033-7380 . 2068224880 Fax 206-8894808<br />

ProJect Name: Fcl ( Project Number: w7.t 005-- O I 7 Client: h- o.c t . - LL.<br />

SamplerS: P c h?k , 3. &&m. P%~/n/g CBFUL) . 'j:. LA,& wdcr~~ ( C hcav ~ecorder: ?, %\k<br />

L<br />

Matrix<br />

# of Containers and<br />

Preservatives I<br />

Sample Number<br />

I<br />

Date<br />

Analysis Required<br />

0<br />

c<br />

z R<br />

2<br />

m<br />

Month Day Year Time<br />

y / STE-SED-161698 - I 10 lb 78 laha 6 r ~ ; n S~CC<br />

Y ( STE - s ED -ID~~SB<br />

- - - -<br />

-2 lb IL ~e 1~a3<br />

P& -SED -lblb98-3A 10 tb 78 1236<br />

y / SE-SED -rblb?8 -3 LO 16 98<br />

-,,-<br />

Y I s LO rL 98 rzq?<br />

/ 10 16 48 1258<br />

Chain of Custody Record (Please Print)<br />

I I I I I 1<br />

Relinquished By: (Name) I Date: I Tlme: I Received By: (Name) I .- Date: I Time: I<br />

Whlta Copy: Laboratory - Yellow Copy: Return to Parametrlx lnc. . Plnk Copy: Pararnetrht lnc.<br />

-..-a

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!