Attachment 6 to Exhibit D.pdf
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- Attached to
- Offsite Analytical Laboratory Services
- Solicitation number
- PO-0000262
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Attachment 6 to Exhibit D
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Text version
Sample Time
21 Days -
COC/Lab Request #:
Project Number:
Sample Matrix
28 Days -
Site Name:
7 Days -
Sample Date
Rad Screening Info:
Lab Reporting Limit Type:
Field Sample ID
Client Contact:
14 Days -
Chain of Custody/Analysis Request Client Contact: Lab Agreement #:
21 Days -
28 Days -
24 Hour - Other -
Analysis Turnaround Time:
Project Number:
Page of
Special Instructions:
Date/Time:Relinquished by:
Relinquished by: Date/Time:Print Name:
Print Name: Date/Time:Relinquished by:
Print Name:
Received by:
Received by:
Received by: Print Name:
Print Name:
Print Name:
Date/Time:
Date/Time:
Date/Time:
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