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CHAIN OF CUSTODY RECORD <br />~~~ Laboratories, Inc. <br />30400 Downhill Drive <br />Steamboat Springs, CO 80487 <br />(970) 879-6590 • (800) 334-5493 <br />P~ctorP.O.q ~~ <br />~V~' Q' i <br />C~i~i. ~,i o~~~~ <br />Shipped va: FELD'rXS,_ UPS_Hand_ <br />SAMPLE IDENTIFICATION DATE TIME <br />Laboratory Sample Numbers (ACZ Use Only): <br />Name to Appear on ReDO>Zand Invoice: i , i <br />Attn: <br />N <br />W <br />~Z <br />Z <br />0 <br />0 <br />i <br />/ <br /> <br /> <br /> <br />cc: <br />r <br />• Metrbr Options: SW (Surface water) • GW (Grountl water) • WW (Wastewater) • DW (Drinking water) • SL (Slutlge) • SOIL • OIL • ONer (Specify) <br />SAMPLE DISPOSAL OPTIONS -Please complete aectlon A, or choose one option trom sections B AND C. <br />Proper charges will bs assessed. <br />(A) Long-term storage (B) It Sample /s Non-Hazardous (C)`ll Semple /s Hazardous. <br />Hold until (date) 1) Local Disposal t) RCRA-Permitted Facility <br />for lulure analysis. 2) RCRA -Permitted Facility 2) Return to Client <br />3) Return to Client <br />RELINQUISHED BY: (SIGNATURE) DATE TIME RECEIVf,,p BY: <br /> <br />/c2GZ <br />COMMENTS <br />one <br />coc q 1427 <br />REMARKS ~~. <br />• <br />DATE I TIME I PAGE q <br />OF <br />T <br />vour <br />