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., ;~ <br />COLORADO DEPARTMENT OF HEALTH <br />CHEMISTRY SECTION <br />REeE~ ~E® <br />QPR 281997 <br />AGENCY: CONTACT PERSON: <br />~%!! ~m.K- ~ rrr7 <br />DIVISION: jt,,~~ ~~,~,~ <br />#O F ed <br />M E T R O D~Clamatip~ n;aor n <br />~ <br />SAMPLER: PHONE #: ~CGrrV.e~~-, <br />x'66-3x67 <br />X s~s~ T <br />A <br />I ~~'~ <br /> <br /> <br />L~ ~ <br /> <br />DATE <br /> <br />TIME <br />C <br />M <br />P <br />G <br />R <br />B <br /> <br />SAMPLE SITE N <br />E <br />R <br />S <br /> <br />~0.`° <br /> <br />COMMENTS <br /> ~~ti /rr,-r/ - ~ s - Zl5 3Z <br /> <br /> ~ - L S3 <br /> 5"3S <br /> ` 5 ~ <br /> <br /> <br /> <br /> <br />RE NQUISHED BY: DATE / TIME <br />(F/ ~ U ~ <br />/~ 9z 9. RE E VE BY: <br />h~~c-~~ DATE / <br />/ ,C TIME <br />~,~F,l SEND FINAL REPORT TO: <br />t3i (/ a rlc f r.-n <br />RELINQUI ED BY: DATE / TIME RECEIVED B DATE / TIME vL,~,,,,,Q ~ ~n /~~' <br />/3/3 ~~i.2rrrw,~. ~ ZrS <br />RELINQUISHED BY: DATE / TIME RECEIVED BY: DATE / TIME L/C.vW~Q,r C~ g'oz03 <br />DISPOSITION: <br />C H A I N O <br />F C U S T O D <br />Y <br /> <br />Z/9l <br />