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TestAme-- - Denver 4 <br /> 4955Yarrm Chain of Custoil Ecord TestAr ca <br /> Arvada,' --_j2 T44E"A_q th&'VwR.oM OITX.TESTM <br /> Phone(303)3)736-0100 Fax(303)431-7171 <br /> Sampler ,, , 11 �^ Lab PK Carrier Traddng No(s): COC No: <br /> Client Information W vs- ` Harrington,Danielle M 280-43276-16771.1 <br /> CuentContact n `' '� , ^�^ Phone: �^ ) E-Mail: Page: <br /> R V�J&d 1 -c.ry (D j ID ldanieAle.harrington@testamedcainc.com I Page 1 of 1 <br /> Company. Job#. <br /> Norwest Corporation Analysis Requested <br /> Address: Due Date Requested: ' Preservation Codes: <br /> 950 South Cherry Street Suite 800 �t A-HCL M-Hexane <br /> City- TAT Requested(days): < B•NaOH N-None <br /> Denver I C-Zn Acetate O-AsNa02 <br /> State,Zip: U <br /> CO,8 0246 PO to <br /> 280-70820 Chain of Custody M G-MeOHAmchl S-HH 2S2 03 <br /> PhonPurchase Order Requested w H-Ascorbic Acid T-TSPDodecahydrate <br /> Email: t✓�I�JIC W O#: [-ice U-Acetone <br /> J-DI Water V-MCAA <br /> Project Name: Project#: a Mix L-EDAA Z--other tsDeci(Specify)Transit x ASK D Harrington for Project Number <br /> SSOWM U Other. <br /> Colorado , <br /> Sample Matrix a <br /> Type (_1 <br /> o <br /> 0 f <br /> Sample (C=comp, ow.'rw, ? e m <br /> cation Sample Date Time G— S ial Instructions/Note:Sam le Identffi <br /> „„.a.: ~•�i+•r.;iv ru. %'o" y -" t 'N��� 5" Q N' �:�d'� �L"n 1 `5 <br /> .. ...:..•.•...,.. .. <br /> CD , :4S Water X Short Holds tinGude: pH,Cr6,300.0 NO3 <br /> N and NO2 <br /> J? <br /> O {.r,r <br /> N <br /> A <br /> Possible Hazard Identification �p Sample Disposal(A fee ma assessed if samples are retained longer than 1 month) <br /> Non-Hazard M Flammable Skin Irritant Poison 8 �`t'Unknown =Radiol ical Retum To Client is sal By Lab Archive For Months <br /> Deliverable Requested:I,11,III,IV,Other(specify) Special Instructions/QC Requirements: <br /> Empty Kit Relinquis f <br /> by. Date: Time: Method of Shipment <br /> Relinquished by. DataR/ime: ny Received Compan <br /> W Relnquished by. Date/fl Company Received by. DetWTirrw Comps <br /> O <br /> tip Relinquished by. Datarrime: Company Received by. DaWnme. Company <br /> V7 <br /> Custody Seals Intact Custody Seal No.: T "c a Other Remarks: t <br /> A Yes A No <br />