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TRE Environmental Strategies, LLC Page I of <br />100 Racquette Drive, Unit A Fort Collins, CO 80524 Phone: (970) 416-0916• Fax: (970) 490-2963 <br />Client/Project Name: <br />Project #: 00 -.-WS - oil 612 <br />Test Requested <br />a <br />> <br />a` <br />� <br />t <br />E <br />o <br />E <br />ro <br />ro <br />Sampler (Prtnt/Aff) atlony: cti / Signature: <br />3i <br />Chain of Custody Tape#: L C-M'Sr Intact7(cucie): No <br />,.`:i'%•'ciR','S.t�-xi.,, <br />Client / Sample ID <br />Sample Collection Sample TM <br />Volume <br />Cort <br />Beginning Ending <br />Date Time Date Time <br />E <br />0-1\ :h <br />•28-15 MMA <br />4-x-15 604 <br />X <br />a -s ..I <br />p"G'L <br />3-3 <br />Sample Relinquished BY: (PrintName/afNlatfon) <br />n2� 1/157 <br />Date: 9-Z0Zr•f5 <br />Time: //' 30 A <br />Date: <br />Time: <br />Date: <br />Time: <br />Received By: (Print� NamIe/AMRatlan) <br />cLL� <br />Date: A A t-;;- <br />Time: <br />Date: <br />Time: <br />Date: <br />Time: <br />Laboratory (Destination): <br />'e'- Pct <br />TRE Environmental Strategies, LLC <br />100 Racquette Drive, Unit A <br />Fort Collins, CO 80524 <br />(970) 416-0916 <br />(970) 490-2963 (FAX) <br />Signa ure: <br />Sig <br />Sample Relinquished By: (Print NamelAf4eatlon) <br />Received By: (Pant NWWAff lfation) <br />w <br />Signature: <br />Signature: <br />Sample Relinquished By: (Print NanwAfBuatm) <br />Received By: (Print Name/ANtnutton) <br />Sample Shipped Via (drde): <br />FedEx Other <br />UP Courier <br />Temp Blank? <br />Yes tKoD <br />Signature: <br />Signature: <br />Comments: <br />Serial No. 00759 <br />