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U.S. ENVIRONMENTAL PROTECTION AGENCY <br />Environmental Services Division <br />REGION VIII, ONE DENVER PLACE <br />99918TH. STREET <br />CHAIN OF CUSTODY RECORD DENVER, C0.80202-2413 <br />Ppn_i NO <br />n /~ <br />r~' t~2~ V PPfI IL(TIJAMF <br />l fl <br />SC's 1~ `~ <br />\/~~(~ <br />~/ ~ <br /> <br /> <br />O. <br /> <br />rr - <br /> <br />SAMPLERS: (Signature) <br />!~'_• q <br /> <br />OF <br />CON- ~ <br /> <br /> <br />r <br />~ <br /> <br />REMARKS <br />- <br />STAT. NO. <br />DATE <br />TIME <br />p <br />U <br />¢ <br />~ <br />STATION LOCATION TAINERS ~ <br />~ \ <br />\ ~~ ~i <br />v <br />r ~% ! ~ 1 ~- ~ o. ~-3 <br /> t r <br />,~ <br /> ~ ~ ,, <br /> <br /> <br />I Y <br />I <br />l ~'~~ , _ 1/ 0, ~' 3 ~ L <br /> <br /> <br /> <br /> r <br /> ImcE~o~ s ° La r' C) It <br />...., <br /> 5 ~ rn(n <br /> ~-- h-•ri /.l. r~. . <br /> /, <br />G / r~lM (.lA <br />_ ~ <br />~ n I <br />~ r <br /> ,.~.j' w, v v~ s C~.lt cv1 ~' ) <br />Relinquished by: (Slgneture) DateRlme Received by: (Slgneture) Relinquished by: (Slgneture) Date/Tlme Recelvetl Dy: (Signature/ <br />Rellnquishetl by: (Signature) Date/Tlme Received by: (Signature) Relinquished by: (Slgneture) Date/Time Received by: (Signature) <br />Relinquished by: (Slgneture) DateRime <br /> <br />4 Received for Laboratory by: <br />(Signature) DateiTime Pemarks <br />Dlsirlbutlon: Orlplnel Accompenlee Snlpment Flret GopY to Coordinator Fleltl Fllee: Second Copy to Representetlve of Inepectetl Facility <br />R8 EPA-014B (4-21-881 <br />$plll Samples: <br />^ Accepted ecline0 Sipnalure <br />8-18381 <br />