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T-a America Denver • <br /> d955 Yarroi Chain of Custoill 3cord TestAnmnca <br /> Arvada, CO. 1 <br /> i <br /> Phone(303)736-0100 Fax(303)431-7171 it It I l Atii N ly f r!'VIr ) 41At if SO INC, <br /> Sampler: <br /> L 1Cl . �� „/ Wt ( lab PM Carrier Tracking No(s) COC No. <br /> Client Information CL (� Harlington,Danielle M 280-52986-19089.1 <br /> Client Contact Phone-•3 G)3 IF-Man Page <br /> Angela Welch 5— ,710 danielle.hamngton@testamencainc.com Page 1 of 1 <br /> Company Job It <br /> Norwes(Corporation Analysis Requested <br /> Address Due Date Requested: Preservation Codes: <br /> 950 South Cherry Street Suite 800 <br /> hi <br /> City TAT Requested(days): A- a N- nane <br /> N <br /> B• <br /> Denver y Dli -N Noane <br /> C-Zn Acetate O•AsNaO: <br /> State,Zip o D•Nitric Acid P•Na204S <br /> CO,80246 _ E-NaFISO4 O-Na2SO3 <br /> a <br /> Phone ^-y E Z F-McDH R- 3 <br /> H2SO47 G•AmChiOt u-H:SO4 <br /> H-Ascorbic Acid r-rSP nudocahydraie <br /> Email. R Lj('97/^/�j WON = _ L n iS I-ice U-Acetorm <br /> 0eeleh@n estcorp.com niiis J-DI Water V-MCAA <br /> project Name Project 0 m Z C C K-CDTA W-ph 4-5 <br /> Colorado Springs Transit 28013507 ra f i ��G a L-CDA 1-other(spoary) <br /> Site 1- $SOWA' a �2 Other* <br /> U) 2 o m <br /> o <br /> Sample Matrix m v a <br /> n <br /> Type (MR r.l.,. LL o ca' L 9 o <br /> �.PIRI, Q U a n G <br /> Sample (C=cop, o.w..L,,u, r o 0 9 x o m <br /> Sam le Identification Sample Date Time G= rab) .r— #-A„ Li n 1 9 i u 1 H Special Instructions/Note: <br /> -•. T s r Preservation C de: <br /> 0) D N S N <br /> (D ��� a-S I� 1�3d Water t Login:shonholds Include IC nitrate,IC <br /> I") nitrite Heiiavalent Chromium! H <br /> o LT'C-� �.aS�i 7 ! 30 Water 71- ,?" <br /> 0 <br /> N Water <br /> ao <br /> Water <br /> 280-99562 Chain of Custody <br /> Possible Hazard Identification Sample Disposal(A fee ma"eassessed If samples are retained longer than 1 month) <br /> Non-Hazard ED Flammable Skin Irritant Poison B I--]UnknownEDRadiological =Return To Client [�Disposal By Lab 177 Archive For Months <br /> Deliverable Requested:I.It.III,IV.Other(specify) Special Instructions=Requiremenls: <br /> Empty Kit Relinquished by: Date, Time Melhad of Shipment <br /> Rellnoulshed by. DatelTime Company Racew Dal ime. Company <br /> OD e uc� 04-►7 5 u5 tJ C4'v1f ��Nr 1 ?Y S <br /> Relinquished by Daterrime Company lie by ` DalejTime Company <br /> N <br /> p Relinquished by DelelTlme Company Recei+ed by UataTme Company <br /> v <br /> Custody Seals intact: Custody Seal No.- Cooler Temperatures)"C and Olhor Re arks y/ ` <br /> A Yes ,% No I, 1-Qr <br />