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ALS Laboratory Group Chain-of-Custody <br /> WORKORDER ^ <br /> 225 Commerce Drive,Fort Cdlins,Cdarado 80524 <br /> TR(800)6 1511 PH:(9]e)dY41511 FX_(gm,'9(F15n Fom Rod <br /> ALS SAMPLER / n / ��, DATE C PAGE of <br /> )�/ / b 5Z 7O� <br /> PROJECT NAME "I ( �l V )tom- �,ven R� PROJECT NO. -Z f.-D/ 5-F TURNAROUND 5 DISPOSAL By Lab or Retum lD Client <br /> FACILITY NAME EDD FORMAT <br /> FACILITY ID(API) PURCHASE ORDER y Y <br /> COMPANYNAME �'�� EN1/f ' BILL TO COMPANY \ry ry <br /> SEND REPORT TO _ INVOICE ATTN TO V i` <br /> ADDRESS 6566 2 ADDRESS \ <br /> CITY ISTATE I ZIPS. [(7� CITY I STATE I ZJP <br /> PHONE PHONE <br /> FAX FAX <br /> E-MAIL E-MAIL <br /> Lab ID Field ID Matrix sample Sample { Prea QC <br /> Data Time neta.a <br /> Z #-Z s 21.21 .it I 1� <br /> 3 S 'z Zi U3o <br /> Time Zme(Clyde): EST CST MST PST Matrix:O=oil S=soil NS=non-soil slid W=water L=11pA E=eAracl F=MIer <br /> For metals or anions,please detail analyles below. SIGNATURE PRINTED NAME DATE TIME <br /> Comments; OC PACKAGE(U W—) RELINQUISHED BY <br /> 1 LEVEL 11(Sb OC) RECEIVED BY A <br /> LEVEL in(SW QC•tome) RELINQUISHED BY �V ". 'V \ �-d�R 1 <br /> Ll .g� LEVEL N(Seac—I_- RECEIVED BY 27 G 0 <br /> 1 . yp) <br /> REUMOL43HED BY <br /> Pressrvalivs Key: 1-HCI 2-HNO3 33H2SO4 4-14" 5-NaHSO4 7-OOwr BA degrees C 9-5035 RECEIVED BY <br />