2008-05-09_HYDROLOGY - C1981035 ‎(2)‎

• Permit No: C1981035
• IBM Index Class Name: HYDROLOGY
• Doc Date: 5/9/2008
• Doc Name: 1st Quarter 2008 Well Water Analysis
• From: GCC Energy
• To: DRMS
• Permit Index Doc Type: Other Ground Water
• Email Name: TAK
• Media Type: D
• Archive: No

Client: GeC ~-~,;,~~~ y L LC..
Contact: ~ ~ ~~ ~/~ fj
Address: y~,r~ y ~ _ ~ _ ~) G
t~~s'-o¢'~eu s c ~ ~'<3Z~
Phone Number. q y p __ 3 ~c'._ ySZ ~~ ~l y
FAX Number. 9 ~ G; ,.: 3 ~ ~ ... y~ 3 ~T
CHAIN OF CUS'~ODY RECORD
I
NOTES:
1) Ensure proper container packaging. Table 1. -Matrix Type
~ 1=Surface Water, 2 =Ground Water
2) Ship samples promptly following collection. ~
3) Designate Sample Reject Disposition. 3 = SoillSediment, 4 = Rinsate, 5 =Oil
P0# G!fti,~ ,~- ¢1 k'~a,i'~. ~ 6 =Waste, 7 =Other (Specify)
Project Name: Samplers Signature: ~-
Page ~ of ~
FOR GAL USE ONLY
GAL JOB #
fl~Y,o~
Lab Name: Green Analytical Laboratories, Inc: [phone] FAX [phone] Analyses Required
Address: 75 Suttle Street, Durango, CO 81303
Collection Miscellaneous Preservative(s)
~ ~;
^ O

Sample ID
Date
Time v
~
~ C
'~ ~
y ~
~ n
:~
~
Comments

d
E..,T H
V
~
y
v V
~~ c c ~ ~ 0. O ,.~ ~ p
v ~w z ~ ~ x x = z o
1. w wLGLC- 3i d Z 2 ~ ~ //W( ~
2. ,~ u~'6~e.,a Ji ~ ~ r' 'l~ Z l~ ~ ,u f
3.,~ av' ~ i~i1/ ~f O~ ~ ~ x' ~r ~ ZZ
a. NA G~-c c li i ~ O~ ~~ Z l~! ~~
s.

7. ~ _
8. ~ ~';,~
9. \i1 •~
10.
Relinquished
. ate: Time: Received by: Date: Time:
~ '8
Deli..°quished by: ~ / j bate: Time: Received by: Q U Date: Time:
* Sample Reject: [ ]Return [ ]Dispose [ ]Store (30 Days)
~. -~