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CHAIN a BUSTD o�D Page of <br />Laborotoriea.mc <br />Client: C�— CO -4 vt %,n. NOTES: <br />Comet:.�tS ►Z 2 t^44 u SG+'� 1) Ensure proper container packaging. a e1.—Mztri7.77RFORCAL oN <br />LY <br />Add=s: 3G'% a cr 3 54- 2) Ship samples promptly following collection. I = Surface Water, 2 = Ground Water GAL 3013 # <br />Gtr 92 j f 7 3) Designate Sample Reject Disposition. 3 = Soil/Sediment, 4 = Rinsate, 5 = Oil <br />._i.: .. . <br />Phone Number.Y�-K rP5_---+• .m-L•--w•s.--r+Was-te,r 7YtiWer(Spr ify)-.W <br />_— <br />FAX Number Project Name: Samplers Signature: <br />Lab Name: Green Analytical Laboratories, Inc. (970) 2474220 FAX (970) 247.4.227 <br />Analyses Required <br />Address: 75 Suttle Street, Durango, CO 81303 <br />Collection <br />Miscellaneous <br />Prese"ative(s) <br />v <br />� <br />0 <br />Sample ID <br />Date <br />Time <br />;; <br />v <br />Comments <br />5 <br />O <br />Q <br />u <br />A <br />.1 <br />z <br />o? <br />s <br />Dec <br />oa�D <br />3 <br />W c <br />836 <br />( <br />� 5132.¢ <br />r <br />3. <br />4. <br />5. <br />6. <br />7. <br />9. <br />10. <br />iroquishedDate: <br />F <br />Time: <br />Recurved b7: — <br />Dae <br />Tisklinquished <br />by: <br />Dau: <br />Time <br />Received by <br />Date <br />Tltr <br />s Sample Reject: [ ] Return 1 l Dispose I I Store (30 flays) <br />