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Chain of Custody and Analytical Request Record <br />PLEASE PRINT; provide as much information as possible. Refer to corresponding notes on reverse side. Page 1 t <br />Company Name: Cotter Corporation Project Name: Schwartzwalder <br />Tracking No. _lZE818322710684734_ Reclamation Characterisation-Pondl and T <br /> REF #/ DATE: 05-29-08 <br />Report Mail Address: Contact Name: Amy Thurlkill Sampler Name if other than Contact <br />7800 E. Dorado Place, Ste 210 Voice: 720-554-6205 Bob Tennant and Amy Thurlkill <br />Englewood CO, 80111 Cell: 303-715-8733 <br /> Email: amy.thudkillocottercc.com <br />Invoice Address: Invoice Contact & Phone Purchase Order ELI Quote <br />7800 E. Dorado Place, Ste 210 Gus Gaviotis <br />Englewood CO, 80111 Tel:720-554-6211 <br /> Fax: 720-5546201 <br />Report Required For. POTWNVWTP ? DW Notify ELI prior to RUSH sample Receipt Temp <br />Other <br />L <br />1 F <br />t submittal for additional charges and ff) o <br />Special Report Formats - ELI must be notified prior to i <br />o." a scheduling oler ID(s <br />sample submittal for the following: m a 8 t Comments: <br />NELAC ? A21-A ? Level IV ? <br />Other s ? <br />X001 < Custody S Y <br /> <br />EDD/EDT Format pl a Intact G <br />Signature <br />SAMPLE IDENTIFICATION Collection Collection >i Match <br />(Name, Location, Interval, etc) Date Time MATRIX LAB ID <br />' Pond 1 (A) 05-28-08 1339 Sediment Species Name I <br />2 Pond 1 (B) 05-28-08 1341 Sediment IS Li Li Species Name <br />3 Pond 1 (C) 05.28-08 1342 Sediment IS i: r- ic [c Species Name <br />4 Pond 2 (A) 05-28-08 1344 Sediment iz r- r- c: r- Species Name <br />e Pond 2 (B) 05-28-08 1346 Sediment <br />C1 <br />r <br />r- <br />r- <br /> <br />Species Name <br />6 Pond 2 (C) 05-28-08 1347 Sediment IS r- r- r- c r r Species Name <br /> Species Name <br />a Species Name <br />e Species Name <br />10 Species Name <br /> Relinquished by: Bob Tennant Date/Time: Shipped by: Received by- DatwTime6-&- <br /> Relinquished by: ..36;3-Date/Time: Shipped by: Received by: Data/Time: <br /> Sample Disposal: Return to Client E] Lab Disposal <br />® LABORATORY USE ONLY <br /> Sam le T pe # of fractions _ <br />ICE <br />9:30 <br />In certain circumstances, samples submitted to Energy Laboratories, Inc. may be subcontracted to other certified laboratories in order to complete the analysis requested. This serves <br /> as notice of this possibility. All sub-contract c