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N~ Cl;'c.l~a <br />~I~t~ CORE LABORATORIES <br />N1ra~terr Aelee <br />Inhernlationel _ _ ____ _ <br />"°"°"'"`°"" ,300 SO.POTOMAC STREET, SUI7E 730 <br />AURORA. COLORADO BOOt 2 (303) 757-t 780 <br />Project no. Client/Project Name <br /> <br />Lab Field Dale n Sample Sample <br />ID Sample No.! and w o Container Type (Liquid <br />No. Identification Time U U ISizelMat'I) Sludge, Etc.) <br /> 93b1o8 t18f93 <br /> x 2-19 P1 wcder <br /> $ML of 90o <br /> ~ l SEl'~.4 Pl ~• <br /> 1-tip A •• <br /> --250..! P- .. <br /> I-11 i~l <br /> C,C1I <br />(' 1 ~ 4 <br /> Ghss <br /> <br />Analysis Request and Chain of Custody Record <br />Project Location <br />Sa>1 Lk,s <br />preser- ANALYSIS REQUESTED <br />vative ri Sce 4~ ~ is 1~1W~~' <br />t}WO3 r~H~-~d .sue Rad„o C_I.,~~.. <br />IFUO; F,I~eh~ fpr ptss. Mc~S <br />Na.r M4 0. ~v~3 - -- <br />-.apl~ Sk~S+dcs - - -- <br />~. Aa <br />u,rxl Gu fse'cb-t + w ~o) <br />W,Sp4 DPI { (7-case <br />~,So~ u+1s N0.. uca, 7oC <br /> 9301013 <br />BMb s4 ~la(1s <br />4on <br />~ • <br />, „ <br />Ir~c 1 <br />Samplers: (Signafurel Relinquished by: Date: IIpIQ3 Received by: Dalc: <br /> <br />to (Srgnafue) ~ ~ ~^ <br />gylq .~1L~47• <br />Time: <br />1300 (Slgna~ure) <br />_ <br />Time: <br /> Relinquishetl by: <br />nature) <br />(Si Date: _ <br />Received by: <br />nafure) <br />(Sr Dale: <br />Aliilialion g Time. g Time: _~ <br />p <br />Bi~Rr Relinquished by. Dale: Receivetl by Laboratory; Date i- j3- <br /> (Srgnafurel <br />Time: (Srgnafure) <br />j <br />time:l2:~ <br />REMARKS: <br />~~eo~~b3 Data Results To; (Name7Addressl <br />-S~.L41s <br />,. S~ ~,MC, <br /> / <br />z. ~. i~alc~ctsc ~M(~ - ~~'' <br />LABORATORY <br />REMARKS <br />--- -- - I <br />- -. _ ,~ <br />$nal No. <br />Laboratory No. <br />~~~~~ <br />White- Return With Results Of Analysis Yellow ~ Lab Copy Pink ~ Samples Copy <br />