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N~ lU~bb <br /> <br />CORE LABORATORIES <br />tr+~`>o.r""n.ow~n `r Analysis Request and Chain of Custody Record <br />•'~""~"~ 1300 S. POTOMAC, SUITE 130 <br />AURORA, CO 80012 13031 751-1780 <br />Project No. Client/Project Name Project LacaNon <br />sa8~ t3~~ MT,.1 Gacr~ sR,~ Luzs co <br />Lib <br />10 <br /> <br />No field <br />Sample No, <br /> <br />Identdication Oase <br />entl <br /> <br />Tim <br />m <br /> <br />t7 n <br />E <br /> <br />U Sample <br />Conuiner <br /> <br />ISi <br />'ll <br />/M Sample <br />Type (Liquid <br /> <br />d <br />l <br />E <br />lereser- <br />ya[iw <br /> <br />A LYSIS REQU TEO <br />p( <br />'~ ( <br />'~ j _ <br />' <br />~ <br />C <br />~"~~- - <br />' <br />LABORATORY <br /> <br />REMARKS <br />. a :a <br />al u <br />ge, <br />te.l <br />S - <br />~ <br />+ <br />~i1, <br />~ <br />~ <br />gk <br /> rZ5 -S 9~~cy~9 (~) <br />' <br /> //00 SOOnIP 82_ <br />C~R7 f~i\/03 lOi~51L `~. 1~i~oW2L) /L1Gi79G~ ~r''-~ <br /> s <br /> I 1 i <br />P@ Hnb 2~i~O Crle.~-( `-+- <br /> soo~l ?E ZaAc SL.r~.F'z t]~ I~Li <br /> 1 L P~ M/-~o2 Aft+a~1S c~ <br /> `f ~ P~ r11noH u1.4~ <br />Cni ~ ~'r74t, ,,,~ <br /> 7 <br /> SCb,.I I G r 6/, so 7a cr of H3 , n~D 3 f n] o u. <br /> 4 L Gt uz~ O r L `~ ~2E,~~, "' <br /> <br /> <br /> <br />Samplers: ISignrrure! Relinquished by: Dere: ~ j ~~`]`~ Recs by: Oale: y /7 COC Seas No. <br /> <br />10 ISignarurel <br />s _ <br />Time: <br />/Ga.p JSign <br />Jr+~ [! <br />Tima: <br /> Reli U~sned hy: <br />- A Dare: ~~~ 7 Rec " by: Pats: <br /> <br />AHilie[ion !Sign <br />~ J/ <br />LLLe -e=LSe -- <br />Time: rCl <br />%~ !S natural <br />Tims: <br />r7rr L~/rF~ ~ /-rSSOG Aeli uishetl by: Dare: Repined by lahore[OrV: Oate: G}//~ Imact: <br /> !Signature! <br />Time: lSignelurel <br />/ <br />Time:' l} <br />REMAAKS: Dau Rear/u To: ( amsl ressl hbpnsory No. <br />F/4 d ~-ESucr 5 a f1r4CEPs45iC/,~ 4- AsSuc.. p3 Snow '• ~CAr~W -^Coi r - ~3/ttC <br />- 9aj~~ <br />/} S /JV.BI er1/3L.a.. 2. j~,4LF j _ +`{ ~c/4 <br />White-Aarurn With Rasuin Of Analysis Yellow-Lab Copy Pink-Serrplas Copy <br />