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1998-03-23_REVISION - M1977348
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1998-03-23_REVISION - M1977348
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Entry Properties
Last modified
6/21/2021 11:09:05 AM
Creation date
11/21/2007 11:44:50 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1977348
IBM Index Class Name
Revision
Doc Date
3/23/1998
Doc Name
EXHIBIT 6
From
Holnam
To
DMG
Type & Sequence
TR3
Media Type
D
Archive
No
Tags
DRMS Re-OCR
Description:
Signifies Re-OCR Process Performed
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<br />CHAIN OF CUSTODY RECORD Laboratory Sample Numbers (AC2 Use Only): (~ Z COC a 15 0 8? <br /> <br />ACZ L Name to Appear on Report and Invoice: cc: <br />SE(oK ' (Report) - (Invoice) to: (circle one or both) <br />nor a ~.fcuvp. <br />aboratories, Inc. <br />30400 D <br />hill D ~?0O H<<(uyvy 5' k~l 32/6. o~ <br />own <br />rive <br />Steamboat S <br />rin <br />C0804(37 (u uj~,~'- <br />~F`( (cu(ns~ SiJ .k i S db <br />p <br />gs, <br />(970) 879.6590 • (t;tX)) 334.5493 C <br />Attn: ~r~rn~ ~i'!~twn Tel: Q'jo-{j~ _y°r~ Attn: N c Tel: r • 6 "L75S6 <br /> <br /> <br />Protect or P.O. IY A NALY SES REQU ESTE D <br />roj ~' Qd X78 - 003 -0 ~ <br />/ W <br />Z <br />a <br />~ <br /> <br />a- <br /> <br />v <br />( <br /> <br /> <br />w REMARKS <br /> <br /> <br />~o~ . <br />ihlpped va: FED X_ UPS_Hand_Other $ J <br />' <br />F <br />~ ~ ~ ~ ~~ <br />iAMPLE IDENTIFICATION DATE TIME Sampe <br />McNw• ~ 1 <br />V T~~ <br />c ~ ilAn lrit!`,r <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />• usiria Oplioru: SW (SuAace wale) • GW (Orountl water) • vnv (Waelswatar) • DW (Drinknp water) • SL (Slutlge) • SOIL • OIL • Over (SpecAy) COMMENTS <br /> <br />SAMPLE DISPOSAL OP710NS - Plesss complete section A, or choose ens opt/on Irom ssef/ons B AND C. <br /> <br />Proper cheryss will be sessessd. i <br /> <br />I <br />) <br /> <br />!A) Long-term etonpe <br />iotd until (date) <br />or future analysis. <br />(B) ll Sample Is Non•Nazardous <br />t) Local Disposal <br />2) RCRA - Permittetl Faculty <br />3) Return to Client <br />(C) ll Sample Is Hazardous <br />1) RCRA-Permitted Facility <br />2) Return to Client I <br />( <br />3ELI HE IGNATURE) DATE TIME RECEIVE BY: SI GNATURE) DATE TIME PAGE N <br />.~ 2~ l /~ ~ ~- 1~y ~ , <br /> OF <br />f <br /> r <br />N <br />I <br />tD <br />O <br />V <br />lP <br />V <br />D <br />n <br />N <br />r <br />w <br />l7 <br />0 <br />w <br />rr <br />0 <br />J. <br />Wtlrte ~ HONm w/ sample ~uivw nmuni w, am uym rnm nv~um n, wuipia bolo ~ Weep lOr your recortls <br />
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