NCS000130 DMR SW (4)

Chain of Custody Record (COC)
f-
used for regulatory purposes?
NPDEs #'
*RUSH work must be approved prior to submitting samples.
Yes
Relinquished
No
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MERITECH INC.
Client: Perdue Farms
Phone:
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Received by: Date: Time:
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Environmental Laboratories
Inc.
Address:
Fax: nh��r
Email:6.,'
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A pivision of Water Technology and Control,
1
Project
Z8 3-l�
Po #:
642 Tamco Rd
Phone [phone]
a -
Turn Around Time*
Reidsville, NC
Fax: [phone]
Attentlion: ,,,
Std (10 days)
3 - 5 Day 24 - 48 Hr
27320
Email: wtclabCar7bellsouifi.net
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Web Site: www.meritech-labs.com
Lab Use only
Sample
Sampling Dates & Times
Person Taking Sample (Signature):
on PK OK? .
-
START pip
Comp? # of
Tests Required
ice? C12 OK?
Location/1D #
Date rune Date Time
Grab?` Conts.
3! 60
G
2
BOD I TSS,CI
Stormvuater
-% 6,0-0
G
1
COD,1402,NO3 (H2SO4)
Method of Shipment:
❑ UPS
[]-Fed Ex
Hand Delivery
+ [Other
q(.00- G 1 Metals - Ptot w / HNO3
G .1 Oil & Grease (w I HCI) (rw hi o*
` 1--1 w g-UU G 1 Fecal Coliform
G H
Will these results be
used for regulatory purposes?
*RUSH work must be approved prior to submitting samples.
Yes
Relinquished
No
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Time:
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Reed Date: -rrime:
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Rellnquis
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Time:
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