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TestAw- i Denver • <br /> 4955Yarro, t Chain of Custody ,cord TestAme*ca <br /> Arvada, CO 80002 <br /> Tlir I rAnrD IN rNVIR(111kIr NTAI TrST1Nr, <br /> Phone(303)736-Ot00 Fax(303)431-7171 <br /> Sampler. Lab PM Comer Tracking No(s) COC No <br /> Client Information K Harrington,Danielle M 280-66800-22620.1 <br /> Client Contact Phone E-Mal Page <br /> Paul Kos dantelle-harnngton@testamericainc.com Pagel e 5 <br /> Company Job s <br /> Norwest Corporation Analysis Requested <br /> Address Due Dale Requested: Preservation Codes: <br /> 950 South Cherry Street Suite 800 Q A-HCL M-Hexane <br /> City TAT Requested(days): B-NaOti N-Non <br /> e <br /> Denver J C-Zn Acetate O-AsNa02 <br /> State,Zip D•Nitnc Acid P-Na204S <br /> CO,80246 s E-NaHSO4 0-Na2SO3 <br /> w w F-McOH R-Na2S203 <br /> Phone' PO K- o w o G-Amchior S-H2SO4 <br /> Purchase Order not required p g H-Ascorbic Acid T•TSP Dodecahydrale <br /> Email WO H, Z s $ I-Ice U-Acetone <br /> pkos@norwestcorp.com N <br /> ° —' J-DIWaler V-MCAA <br /> Protect Name Protect p m a o K•EDTA W-pH 4.5 <br /> Colorado Springs Transit 28013507 ° ° L-EDA Z-oche (specify) <br /> Site ssowa other: <br /> c w <br /> Sample Mattix C mI Z n �I rn E <br /> Type (W—OW $ N <br /> 5-4d. � E or <br /> Sample (C=comp, p. x.,p�, o Z i o F� <br /> Sample Date Time G= rab Sample Identification Special Instructions)Note: <br /> c0) _ Preservation Ccoe: D N/ N D N <br /> Cn �.i:m— G W t'— G Y i'8—t7 �U($' G CD <br /> Water yC ✓� <br /> O Login.Shortholds Include pH.IC nitrate,IC <br /> O LTA- C�t'`f— 6 Si+ �'1�-17 �� G Water 1< X nitrite <br /> Water <br /> 4 <br /> Water <br /> Wafer <br /> Water <br /> Possible Hazard Identification Sample Disposal(A tee may be assessed it samples are retained longer than 1 month) <br /> =Non-Hazard =Flammable Skin Irritant Poison B Unknown Radiological =Return To Client =Disposal By Lab Archive For Months <br /> Deliverable Requested:I,11,111,IV,Other(specify) Special InstructlonslOC Requirements. <br /> Empty Kit Relinquished by: Date. Time Method of Shipment <br /> Rohnquls DalelTlme ` Co rT"mpany Rec ved by _ Dale e. _ Co}m-p��JnyN <br /> ... —( C '�7 J r rT�l/ <br /> 00 Relinquished by: Dalerrlme Company Received by DalelTime Company <br /> N <br /> CO Relinquished by, Dalerrime Company Received by Date?,me Company <br /> IV <br /> O <br /> Custody Seals Intact, Custody Seal No., Cooler remperaturew°C and Other Remarks <br /> 4 Yes a No <br /> 0 <br />