Laserfiche WebLink
N4 <br />~~~ <br />CORE LABORATORIES <br />i e«~.e'"b."°.1 Analysis Request and Chain of Custody Record <br />•"x'0'-'6'^ 1300 S. POTOMAC, SUITE 130 <br />AURORA, CO 00012 13031 751-1780 <br />Project No. Client/Project Name Project Location <br />Sr}~LI ~~:c~~~lt- 1~1.1,J. CL~ILk ~y1rJ ;_CI+S <br />lab <br />ID Field <br />Sample No. Data <br />and <br />n o, <br />E Sample <br />Cpn[ainar Sample <br />Type /Liquid <br />Prater- <br /> <br />ANALYSIS REQUESTED <br />LABORATORY <br />REMARKS <br />No. tdeml/reai[ion lime c7 v (Size(Mat'll Sludge, Etc.l votive ~c ~(:E ~r,:ey~ ~i rv %-- Q~,ur''.LL C`,jl <br /> 9a>a(o ial`~/~a <br /> 6r`iGo 3 /,So '~ SEx~.a1 •,'~, a~n ~;_r /Ir.Y~~ JISj'~~_ x;n /%'iz roc <br /> ia~ <br /> <br /> '~L Pc (~aUN C,J ~iU~r7L, t'~.a~, <br /> <br /> <br /> 'I L L L. i~lz~~=y C+ L Y GrZG kSL <br /> 5~,~.1 61 ,{ZS.'y Z~C, /`luZ n,~~~ I r~)C~3 <br />Semple <br />A <br />r-lAIaPA <br />REMARKS: <br />F~ <br />rs: rSipnsrursl Relinquished by: <br />rSipneture) 2 <br />Relinquished by: <br />ffiliation /Sipnarursl <br />~.yl `', ~L,L Relinquished by: <br />/Sipnarursl <br />PO ~ C~oC~~'~ <br />/2ESL.1Lr5 7'Q NA~c/ASt4A cS /~s~tc <br />Date: ,(.~~ir~9d Received by: <br />J ~ 3 ~ <br />Time (Sipneture) <br />Dale: Received by: <br /> (Sipneture/ <br />lime: <br />Date: Received by Laboratory : <br /> rSigneturel <br />lime: <br /> Data Rewlts To: (Name ) Address) <br />' <br />7ra <br />Y -.~ `15 <br /> 2.2. iopP~2 - ~~cnr~~lcra <br />Data: /;[/I <br />Timer ~ <br />Date: <br />Time: <br />Date: <br />Time: <br />Seel No. <br />Intact: <br />Laboratory No. <br />~Z~z~ <br />White -Return With Results Of Analysis Yellow -Lab Capy Pink -Samples Copy <br />