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N° 10098 <br />'~~~ <br />CORE LABORATORIES <br />It:;cer~', o si Analysis Request and Chain of Custody Record ' <br />"~'°"~`^ 1300 S. POTOMAC, SUITE 130 <br />AURORA, C0 80012 (3031751-1780 <br />Project No. Client/Project Name Projetx Location <br />5284 (~.ZL.e N[TN Ccx-'9 s,~,~ LU rS <br />Lab <br />ID Field <br />Sem le No. <br />P Date <br />and <br />m n <br />E <br />o Sample <br />Container <br /> <br />' Semple <br />T <br />Ype (Liquid <br />Preser- <br />votive <br /> <br />ANALYSIS REQUESTED <br />LABORATORY <br />REMARKS <br />No. Identification Time l7 U ISixe/Met <br />l) Slutlge, Etc.) <br /> ~JZiOZ6(3M6 <br />Q3 b~2(,/42 <br />13 u Z Sa'.'ml <br />Pc <br />~.U~r~R H,.fU <br />S <br />To ~ nc. + 'D <br />eD M e-T•qL <br />S <br />L <br /> o , ; <br />v <br />So <br /> <br />,. <br />.. <br />Y z-/2 P~ „ <br />ku j <br />1; ~Dta Cb,erh <br /> <br />-' ,~ <br />~ ZSO~„t „ Sao <br />S'~ <br />R <br />~ <br /> Po ~ <br />i <br />e <br /> 'r 1. n t L <br />G~ ti M ~. <br />z.4-'y <br />~ I i. .} ~C'P_41' <br /> s s , i !~ Scm ~tr„ t , N~Sr; ~TC) C .V tl <br />NG •+NO <br /> r .. <br /> ,t t. x ~ ~ Pc•' ,. <br />nkY.,e <br />M A Sa'R .~ ~' ~o.v$ <br /> tt " ~ j Q Pc " NLC~H C/.i ~Tc~iYl-L L WAD <br /> <br /> <br /> <br />Samplers: /Signature) Relinquished <br />` Q <br />-' Date : iC:(z,p,Jci2 flecaivad by: Date: COC Seel No. <br /> (Signeturel ~~ ~ <br />L r1 T <br />. <br />G~ O <br />Time: i (Signerurel <br />Time: <br /> Relinquished 6y: Date; fleteivad Dy: Date: <br />Alfilietion (Signerurel Tima: (Signature/ Time: <br />P4$l~4 Y RSSOG Relinquished 6Y: Date: Received by Laboratory: Dete:p~, r Intact: <br /> (Signsturel <br />Time: (Signarur 1 <br />/ ' Ch / ~. <br />Time: ~d' <br />REMARKS: Data Results To: (Name/Address) Laboratory No. <br />~~~ t2csL,crs rL, ~(Ac.L(7l~VCA .h ,~ ` <br />.~~~ ,. q~.s~.~-~ ~~M~a <br /> <br />~ ~ <br />cr~~ - ;, 2~rs <br />' <br />2. ~ -T <br />Pt~« <br />~ <br />~~ 19 <br />~' 9 <br /> ~ <br />; <br />Al.:=o~',~~ t-a-ss«.~ <br />White -Return With Results OI Analysis Yellow -Lab Copy Pink -Samples Copy <br />