Laserfiche WebLink
�eaCrae +tGraana <br />AN INVIRONNlNTAL OiRTICKS COMPANY <br />CHAIN OF CUSTODY 500 S. Arthur Avenue, Unit 450 - Louisville, CO 80027 <br />(303) 661.9324 - FAX (303) 661.9325 <br />Client/Pro ect Name: zl„ <br />Analysis (Check all appilcable) <br />P.O./Project Number: T <br />oo <br />�, <br />d <br />° <br />= <br />a <br />a <br />m <br />m <br />V <br />" <br />O <br />o <br />m <br />m <br />U <br />c <br />a <br />ai <br />a <br />o <br />m <br />U.zy� <br />c <br />LL, <br />W <br />E <br />- =� <br />4 <br />" <br />;:� <br />`.r <br />^� <br />m <br />xt <br />N <br />d <br />Am <br />h <br />y <br />y <br />E <br />= <br />E <br />W <br />L <br />U <br />W <br />E <br />u <br />Uj <br />R <br />W <br />o <br />E <br />u <br />G <br />o <br />o <br />°o <br />R <br />a` <br />3 <br />Contact: <br />Address: 2Zt�4c. > Z g i <br />Phone # °1W 9&4 10 7:5 <br />E Mail: 'T = _ t�ICL, <br />Fax # 'BG� 4.1 (vg <br />Sampler: <br />Report By: ❑ Mail ZJPDF ❑ FAX <br />! <br />Sample Location or ID <br />Date <br />Time <br />; <br />3 <br />3 <br />r- <br />TR <br />a` <br />u <br />a <br />° <br />0 <br />1l i <br />nei?o uFrew ts'' <br />t r s :.:i; <br />Test Spades: Fathead Minnow <br />Ceri i daphnia <br />Daphnia magna Q <br />DWhnis pulex ❑ <br />Other (List Below) <br />Standard (10 days) 6 -9 Day <br />Special instructions /Comments: <br />3-5 Day 1 -2 Day <br />Requested Report Date: <br />.: :- ��uishJ <br />�: - : w• :. - q±ec::. <br />��_ <br />•.s <br />ritefiriquisf�ed8 <br />:r <br />°", B - <br />? :.. -. :.r.�:- <br />.. ..:. - s szan:— . . s-' _: a <br />. fi .r4:.•e•ana .. .. .: . _ - gm"•�- <br />- <br />Signature <br />Date/Time. Signature <br />UateMme <br />Signature <br />Date/ rime <br />Signature <br />Date/Time <br />• <br />