Laserfiche WebLink
<br />',~ <br />,~ CORE LABORATORIES ° <br />tllhetws AGee <br />International <br />Analysis Request and Chain of Custody Record ' <br />""""^" 1300 S. POTO MAC, SUITE 130 <br />AURORA, C080012 (303)751-1780 <br />Project No. Client/Project Name Project Location <br />5agu 3a+~<< MfN. Got_O 5qr~ c-tars <br />Lab Fieltl Date n Sample Sample <br />ID Sem le No. <br />P end m E <br />o Container <br />ype (Liquid <br />T Praser~ <br />ANALYSIS REQUESTED LABORATORY <br /> <br />No, <br />Itlantifit:ation <br />Tima <br />t7 <br />O <br />(SizelMat'1) <br />Sludge, Etc.) vatlve <br />~I: SEE TA/~ 1 Fort- taMPLETE C.rSt REMARKS <br /> /o/rs/9a <br /> M_9 //k0 ~~l Pt° WA7~2 HrJO l~1SSoLJtd~ NlET'At_S <br /> c a~ <br /> iL ~ NNu rZAOio C61EM <br /> 9 L. Pc tynoN Cnl ;v« L- w Ro <br /> iL PE A.JRJo2 AyJro~.tS <br /> gso,,.t ~ 2aA Sut~','pt2. <br /> 1L. Gt tat.So ©lL. 4 62u~9SE <br /> ~or.l 61 I{2So A/0 <br />~ IlO <br />ioc <br />r[Nz <br /> y 3 <br />r <br />d <br />1 <br /> <br /> /%S/9 ~ Shr`k q S <br /> /29-/~ /yao ~ A3o.lc WAt22 $AMG AS /43oVG <br /> <br />Samplers: /Signature! Relinquished by: Date : /O//C V a Received by: Date: COC Seal No. <br /> <br />1 o (Signeturo) 2, to /yuc, <br />Time: lSigneturel <br />Time: <br /> Relinquished by: Date : Received 6y: Date: <br />Affiliation /Slgnetuiel <br />Time: /Signature! <br />Time: <br />^ <br />!(y¢[t~pA31C.A i~ /•,bpC. Relinquished by: Date : Received by <br />o <br />ratory: <br />Lab Date: Q.~b.C}dlntact: <br /> lSigneturel Time: - <br />y <br />L <br />lSigneturel ~.~G/ ~ ~r ~7 Time: <br />REMARKS: Date Results To: (Name! Address) Laborstory No. <br />FA>< RESu~iS To NrtLEn/a3CA ~ AbSoC. 744-38 45 1 /}LAr.1A $C1JI r - ~'1G <br /> iZA/~ ioPPF2 Nht.t~SCr4 <br />2 ~~~~~> <br /> . <br />White -Return With Results OI Analysis Yellow -Leh Copy Pink -Samples Copy <br />