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~` <br />' '~ Colorado Analytical <br />~LaboratGries, lne. <br />CHAIN OF CUSTODY RECORD <br />Colorado Anaiyti~al <br />Laboratories, (nc. <br />" ""' """' ~7 ~ ~~ ~~~ PROJECT ID / <br />DESCR <br />IP <br />O <br />N <br />: <br />CITY/ST/ZIP: . `/~ ~? ,~"~ l <br />~,. yam, <br />/ <br />' <br />- ` ~ <br />_ <br />W <br />' <br />~„~G'/~ S <br />TELEPHONE: <br />3~7 3 P = ~~,~ / ~/l~ SAMPL D B <br />Y <br />: <br />FAX: °^ ~ .~ °'~ .~~ P.O. NO.: <br />Sample Matrix (circle One): ~ _ <br /> <br />DRINKING WASTE RO D SURFACE SOIL S <br />LUDG <br />-. _ <br />WATER WATER ATE WATER a `' ~ ~ ;~ _~ f <br /> F_ <br />- ~~ ~ <br /> <br />OTHER (Specify): , <br />~~ ~ (~ <br />~ o <br />~ ~~-' ~~ <br /> <br />DATE <br />TIME <br />CLIENT SAMPLE ID: ~ m-~ <br /> <br /> <br />~ ,, <br /> <br /> <br />s <br />1 <br />~' <br /> <br />~ <br />~ <br /> <br />~ ~~ u <br />e <br />~ ,J <br />2 L / !?S ClIl~?Gtf-C~ / <br /> ~ <br /> <br />~ 3 ~ ~_ <br />~~- <br />-;+ <br />COMMENTS: <br />RELINQUISHED BY DATE/TIME R <br />22C~ <br />240 S. St. Brighton, CO 80601 <br />P.O. Drawer 507 <br />240 South Main Street <br />Brighton, Colorado 80601 <br />303-659-2313 <br />FAX: 303-659-2315 <br />ONLY <br />:~ o~3s~1 <br />LAB # ~ ~~~~~ O~ <br />LGN <br />LOC <br />OC <br />DISP <br />DUE <br />REPORT~RESULTS <br />'~'O C DH Y c: ~ _ N <br />~LHINr; N ' ~I;~gTFu '; - - <br />PI!ECC l^.~,~,TEi?`SUPf'L ~ ';?-nFL <br />P1NSfD <br />~~ ---- - <br />S'lS fwf.ME. <br />~QDRE65 <br />CITY.'5TATE' <br />ZIF', ~~_ <br />DELIVERED SY <br />DA~~ lytEz IBS RELINQUISHED BY DATEITIME RECEIVED BY DATE/ TIME <br />659-2313 fling Address: P.O. Drawer 507 Brinhtnr, rn Qnt;ni <br />