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• <br /> <br />W.E. T'. ~nG <br />Water & Environmrnta! Testine /nc 235 West 400Svu/h. American Fork. Utah 8J003 (801)763-0660 Fax (SOIS763-04dD <br />Chazn of Custody Recard <br />C}lstomer. ~~ l.~oruza~ Sampler. ~ /<~.- <br />5ampte Date: 2~ _ ~_ r, , Project: <br />Sample Information <br />Sample N Date Time Composite/Grab Location Analysis Requested <br /> ZG IJcLcryi~ <br /> <br />r ~ <br />.2q-/j tVPoes ooT wtT' h-sT ~!s -c <br />~y~ <br />~ r <br />2r~ Vczo <br />' < <br />G ~,A?~s~g <br />v.rC" ~r ~sz,K/~ <br />~.fz_ <br /> <br /> <br /> <br />Sample Castodv Record <br />Re • --'-'-^a l Received by: <br />BPS DateJTime <br />. <br />Relinquished by: Received by: DatelTime <br />vP~ .~io'e-e. rv-a-~-al q~3~.fv~ <br />Relinquished 6y: Receiv Date(Cime <br />1 G-o~-e h-Z7-~Y S-`3a <br />Sample Re ~ived is Lab by Da ime <br />v E'~~-F ~~-7- -II ~~Zl°Fi7vL <br /> <br />Temperature Received in the Lab: Effluent: y• 9~ ~G ~~ <br />Receiving Water: ~• g ~G (3~P <br /> <br />coax: was la~ <br /> <br />Else la_ a.m na:.c.r <br />w.l:T.lac Caasier <br />Sidppod~ A.rl.od la <br /> <br />.~/IY.I swpta <br />C1rtad~Snls Used Y ~ <br />[atact Y/H Samges- <br />(.HOC sad LMls MstrL? <br />Yes_~ <br />Noce No <br />Sro4rA / Leatis~? Cosra[ Usd! SdAdcsd QasnHq SafFaims QuatN~ o[ <br />Ya <br />No V.._ <br />_ Yee <br />IYo ~ Suple! <br />Ya ~ aed3Aq Water! <br />Yes <br />/~ !(o No <br />