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_n <br />ANALYTICA <br />ENVIRONMEN"I'AL <br />LABORATOI2lES _ <br />CHAIN OF CUSTODY RECORD <br />325 Interbcken Parkway, Suite 200 <br />Broomlield, Colorado 80021 ' <br />(303)469-8868 or 1-800-873-6707 _, <br />FAX: (303)469-5254 <br />CLIENT NAMEE ( <br />~ rC ~ ~ <br />~ CLIENT CONT~AC,T <br />~ ~~ <br />r s ANALYTICA <br />USE ONLY <br />N~ aogs~o <br />CLIEN <br />DDRES; PROJECT ID/D <br />RIPTION <br /> ~(Q-o3-©S~ --- <br />CSN <br />TELEPHONE <br />LGN <br />FAX P. O. NO. _~f3 O TESTS REQUESTED _ <br /> Loc <br />Sample Matri ircte one) <br />WATER S IL OIL SLUDGE No ~ oc <br />OTHER (specily) <br /> <br />er matrix) <br />(NOTE: use one Ch <br />in of Custod of <br />BORLES ~ <br />J ~ <br />. <br />PM <br />y p <br />a ~ ~. <br />'J <br />DATE TIME CLIENT ID ~ DUE <br /> <br />/~ ~~ q ~-o3-oS - of ~ _ I <br /> <br /> l'f=cam' -0 3 <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />COMMENTS S - ~ ~ Y ~ ~' ( V ~ ~{~ I~ 7~ Q L ~ ~-S ~C~O~"(.~~ MEANS OF DELIVERY <br />RELIN ISHED BY DATE/TIME <br />3-- l'-I - 4,b RECEIVED BY DATE/TIME RELINQUISHED BY DATE/TIME RECEIVED BY DATErtIME <br />9 13 0 <br />