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G <br />v <br />Inter-Mountain /~ <br />Laboratories, Inc. //~//-T I/{~/// /~ y- <br />CHAIN OF CUSTODY RECORD <br />RECEIVED <br />nFC n s ~nn~ <br />CIIenUProjed Name <br />~' ~ Project Location <br />~~ <br />c <br />ANALYSES / PF~9'/41N~~FRSaIs and Geology <br />Samp er: (Slgnature) Chain of Custody Tape No. <br /> <br /> <br />Sample No./ <br />Identification Date Time Lab Number Matrix <br />m r Remarks <br />_~ ~ 4 <br />° c w <br />z~ tiQ ~ <br /> ~ :~ ~- 2 <br />0~ <br />9 /,~9rP~t ~, ~ <br /> / <br />?/ ~~ ~ <br />g <br />i(~8 At~rN S ~ ~ <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />Rellnq by: (Slgnature) ate <br />~ ~(oz Time <br />1(~ 3 Received by: (Signature) Date Time <br />R Ished by: (Signature) Dat Time Received b Si nature <br />Y: ( 9 ) <br />Date <br />Time <br />Rellnqulshed by: (Slgnature) Date Tlme Received y I ato Ignatur) 0 to T/r'ime <br />11. <br /> <br />~ <br />555 Absaraka <br />Sheridan, Wyoming 82801 <br />Telephone (307) 674-7506 Inter-Mountain Laboratories, Inc. <br />~ O O <br />1633 Terra Avenue 1701 Phillips Circle 2506 West Main Street <br />Sheridan, Wyoming 82801 Gillette, Wyoming 82718 Farmington, NM 87401 <br />Telephone (307) 672-6945 Telephone (307) 682-8945 Telephone (505) 326-4737 <br />~ <br />11183 State Hwy. 30 <br />College Station, TX 77845 <br />Telephone (979) 776-8945 <br />~`~~~ ~ <br /> <br />