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Company Name /Address <br />Molen & Associates, LLC <br />2090 East 104th Ave Suite 205 <br />Thorton. CO 80223 <br />zz <br />x <br />3 <br />aw <br />x a <br />E ° <br />Z <br />t°on w <br />CLa <br />m x <br />m <br />� Y <br />Q Q <br />+ m <br />U Q <br />Y U <br />cc <br />Z M <br />U <br />Matnx: SS- SoiVSolid GW- Groundwater WW- Wastewater DW- Drinking Water OT- Other <br />Remarks. <br />B114 <br />mtainer/Preservatwe Chain f LC I d <br />PageofL <br />Report to Mark Molen <br />E -mail to molenassociates @ gmail.c <br />Dlect Description. Broda At Inert Fill <br />( 9 ( w <br />Samples retumed vie FedE PS_Other_ <br />ONE 3034501600 <br />c 303.452.4515 <br />Cllerd Project No. 10 -0133 <br />Lab ProjectI <br />I- ,( {`, r <br />SRNFaelllty ID# Brody Al <br />P O # <br />acted by(eg ure) <br />ked on Ice N Y <br />Rush? (Lab MUST be Notified) <br />Same Day .200% <br />Next Day. 100% <br />Two Day. 50% <br />Date Results Needed <br />Email? No - Yes <br />FAX1 No Yes <br />Sample ID <br />MW -1 <br />Comp/Grab <br />Grab <br />Matrix <br />9w <br />Depth <br />Qete <br />ri0 <br />Time <br />E• ( C <br />MW -2 <br />Grab <br />gw <br />d <br />o_ <br />J <br />MW -3 <br />Grab <br />gw <br />z <br />_ <br />w <br />zz <br />x <br />3 <br />aw <br />x a <br />E ° <br />Z <br />t°on w <br />CLa <br />m x <br />m <br />� Y <br />Q Q <br />+ m <br />U Q <br />Y U <br />cc <br />Z M <br />U <br />Matnx: SS- SoiVSolid GW- Groundwater WW- Wastewater DW- Drinking Water OT- Other <br />Remarks. <br />B114 <br />mtainer/Preservatwe Chain f LC I d <br />PageofL <br />PH Temp <br />RReeiiooaa <br />R •u� b' <br />ReWpuieber by(Sgnature ,. <br />D yyy <br />.291 <br />7me <br />Reoeiwd by.(Sgmture) <br />( 9 ( w <br />Samples retumed vie FedE PS_Other_ <br />Prepared by: <br />Dade <br />Time <br />Received by ( Sgnature) - <br />�P: 3 <br />Dale: <br />6otlbs Repaired, <br />rMW <br />ENVIRONMENTAL <br />7. <br />Science corp <br />12065 Lebanon Road <br />d <br />o_ <br />J <br />Mt Juliet TN 37122 <br />z <br />_ <br />w <br />Phone (615)758 -5858 <br />LLJ aw <br />li <br />Phone (800) 767 -5859 <br />O <br />T <br />0 <br />o <br />FAX (615)758 -5859 <br />x <br />iT <br />z <br />E <br />3, <br />E <br />N0 <br />CoCode (tab use only) <br />.- <br />C <br />MOLENTCO <br />CL <br />o <br />TernplatwPologin <br />z <br />to <br />N <br />d <br />Q <br />L) <br />0 <br />NShipped <br />via: Denver Service Center <br />CL <br />Co <br />O <br />cc <br />> <br />Remarks /contaminant <br />I Sample # (lab onlv) <br />PH Temp <br />RReeiiooaa <br />R •u� b' <br />ReWpuieber by(Sgnature ,. <br />D yyy <br />.291 <br />7me <br />Reoeiwd by.(Sgmture) <br />( 9 ( w <br />Samples retumed vie FedE PS_Other_ <br />Omer <br />Condry'en �� trobpep <br />PH Checked NCF: <br />Dade <br />Time <br />Received by ( Sgnature) - <br />�P: 3 <br />Dale: <br />6otlbs Repaired, <br />rMW <br />Rekrputsher by (Signature Dale Time R fprlaD by. gneture) -, <br />7. <br />