Laserfiche WebLink
, <br /> CITY OF EVERETT <br /> ENVIRONMENTAL LABORATORY <br /> CHAIN OF CUSTODY <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> Phone: (425) 257-8230 Fax: (425) 257-6033 PROJECT# <br /> :2*..'• <br /> DATE: / <br /> ENT: ADDRESS: <br /> City c..11. ii,veret, 3a/0 Cedar Street <br /> IOGRAM: SAMPLE SITE: <br /> prev Alieu-Buick ProperLv LverkItt, V:A. 94201 <br /> PHONE: COLLECTED BY: REQUESTED BY: <br /> ,,.... <br /> ANALYSIS REQUESTED <br /> equested sample report date(If less than 30 days): fIli <br /> 111 <br /> 1 RPOSE: <br /> [] IN LAB <br /> CONTRACT D OUTSIDE LAB <br /> CONTRACT 4 f , <br /> SAMPLE LIMS ID# SAMPLE SAMPLE COMP SAMPLE <br /> DESCRIPTION: (Lab Use Only) DATE TIME GRAB MATRIX <br /> I <br /> I <br /> I <br /> I . <br /> I <br /> I , <br /> •INDICATE:LAB PERFORMING ANALYSIS/#OF CONTAINERS <br /> CHAIN OF CUSTODY - ' I '41, <br /> E <br /> ikt / fillf , 9ATE.. ' ,1 TIII <br /> elinuished Received .i.....- , <br /> i <br /> / DATE TIME <br /> *Relinquished: *Received: <br /> elinquished:i *Received: DATE TIME <br /> DATE TIME <br /> elinquished:t *Received: <br /> COMMENTS: <br /> Seimd copy ui report toi J Soadexg4c.rd/24ik,tud LarLit Scit,..tkIceb, Iiic. <br /> 1. .:',1h Avidr.ua$, Su1t;i7. IOC, t...irkialid, WA 96033 <br /> ecause the City of Everett Environmental Laboratory is a public agency, data, test results, reports and other documents are public <br /> ords and therefore subject to disclosure to third parties upon their request pursuant to RCW Chap. 42.17. <br /> E-ARCC(9/06) DATABAR,INC. <br />