Laserfiche WebLink
ALS Envipenmental <br />8620 Holly Drive, Suite 100 <br />Everett, WA 98208 <br />Phone (425) 356-2600 <br />Fax (425) 356-2626 <br />ALS http://Www.alsgiobal.com <br />Chain Of Custody/ <br />Laboratory Analysis Request <br />AI.S Job# (Laboratory Use Only) <br />V1 7 03-0 1 Zj <br />Date 317401-7 Pace I Of <br />PROJECT ID:. "37ANALYSIS <br />REQUESTED <br />OTHER <br />(Specify) <br />REPORT TO I <br />COMPANY: "Adat LA <br />el <br />a. <br />>< <br />(D <br />❑❑ <br />g <br />< <br />LU <br />.8� <br />nw8a<-Z' <br />❑ <br />LU <br />X <br />CD <br />�Q <br />co <br />LU <br />.8, <br />0 <br />CO <br />< <br />LU <br />LU <br />C'j <br />Z� <br />76 <br />Cq <br />COul <br />" <br />e <br />0 <br />V5 <br />C, <br />to <br />&i <br />LLJ <br />LU <br />w <br />IR <br />C� <br />co <br />m <br /><GL <br />UJ <br />LU <br />LU <br />al <br />< <br />.8�1 <br />-0 <br />, <br />CL <br />�2 <br />- <br />co <br />wi <br />0 <br />X <br />IE <br />2 <br />< <br />❑ <br />LU <br />co <br />LU <br />❑ <br />❑ <br />CL <br />co <br />❑ <br />�2 <br />El <br />v, <br />w <br />a- <br />ED <br />ff <br />< <br />�j <br />41- <br />H <br />kn <br />PIS <br />CV: <br />wo <br />(r <br />Lu <br />Z <br />0 <br />Z <br />0 <br />U- <br />0 <br />m <br />z <br />C'. <br />z <br />0 <br />t= <br />z <br />8 <br />0 <br />0 <br />0 <br />z <br />> <br />uj <br />PROJECT <br />M 0 ANAGER: ge-clr� <br />ADDRESS' ISO 2nj ve- <br />0 2.0 <br />PHONE: 4.15 -3 ?-q 30 -7 FAX: <br />P.O. it: L419 Gi I E-MAIL- � �eA� tA 14 to <br />INVOICE <br />PA <br />COMPANY <br />ATTENTION: .3, <br />-4 <br />ADDRESS: <br />Ldinmads V4- 0 <br />SAMPLE I.D. <br />DATE <br />TIME <br />TYPE <br />LAB# <br />1. 8-2 S-2 <br />q100 <br />Sold <br />x <br />1xx <br />q!su <br />So I <br />X.xj <br />I X <br />x <br />I <br />3. <br />1511q1j <br />I c., 0c, <br />So 11' 1 <br />f 3 <br />1�< <br />X)� <br />I x <br />K <br />4. <br />T//q//-7 <br />10.13-0 <br />sv'] <br />f 4 <br />1 X <br />I <br />I <br />>XX <br />I <br />X <br />5. D I <br />311 <br />11!�o <br />S-011 <br />Is <br />6. <br />7. <br />8. <br />N, <br />9. <br />110. <br />TFT-FT <br />NKFI-1 <br />SPECIAL INSTRUCTIONS <br />SIGNATURES <br />1. Relinquished <br />Received By: <br />2. Relinquished <br />Received By- <br />4w m m <br />TURNAROUND REQUESTED in Business Days* <br />Organic, Metals & Inorganic Analysis OTHER: <br />170 75 72 F11 Specify: <br />Fuels & Hydrocarbon Analysis <br />F51 73 <br />