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0-7 <br /> PaceAnapical Pace Analytical - CHAIN OF CUSTODY RECORD - Page of <br /> Sheridan. WY and Gillette WY All shaded fields must be completed. # <br /> This,s a legal document any misrepresentation may t:e construed as fraud <br /> Client Name Project Identification Sampler(Signature/Attestation of Authenticity) Telephone# <br /> Grand Island Resources Waste Rock Characterization <br /> Report Address Contact Name ANALYSES / PARAMETERS <br /> PO Box 3395 Seab Muller <br /> Nederland Co 80466 Email smuller@nedmining.com o <br /> Invoice Address Phone 208-582-3218 N <br /> A <br /> Same as above Purchase Order# Quote# � <br /> z REMARKS <br /> LAB ID DATE TIME SAMPLE rscf m <br /> w Lab Use Only) SAMPLED IDENTIFICATION Matrix Containers Q <br /> ',l 7( !l 1 1 07/20/22 1000 607747 SD 1 <br /> DAvid `(ouwol # ## 16 00 c a A 22L a <br /> U UPS Water 1NT Check desired service Compliance Monitoring ? N <br /> 0 Fl Soil SL ❑ Standard turnaround Program (SDWA, NPDES,...) <br /> ❑ USPS Solid SD EI RUSH - 5 Working Days PWSID/ Permit# <br /> ❑ Hand Carried Filter FT ❑ URGENT - < 2 Working Days Chlorinated? N <br /> U OtherPace Analytical Other OT Rush Urgent Surcharges wi1/bV*VpWWmo Ste{ osal. Lab x Client Rev 4 7 Web <br />