Laserfiche WebLink
Analytical <br />CHAIN OF CUSTODY RECORD <br />NOTES: <br />1) Ensure proper container packaging. <br />2) Ship samples promptly following collection. <br />3) Designate Sample Reject Disposition. <br />PO# <br />34,. <br />Project Name: 9,GAZ_ r- ? jeiwC j[ <br />Table 1. - Matrix Type <br />1 = Surface Water, 2 = Ground Water <br />3 = Soil/Sediment, 4 = Rinsate, 5 = Oil <br />6 = Waste, 7 = Other (Specify) f- <br />S <br />Page of <br />FOR GAL USE ONLY <br />GAL JOB # <br />Lab Name: Green Analytical Laboratories, Inc. (970) 247-4220 FAX (970) 247-4227 Analyses Required <br />Address: 75 Suttle Street, Durango, CO 81303 <br /> Colle ction Miscell aneous Pre serv ative (s) <br /> z T <br /> <br />Sample ID Date Time 0 Comments <br /> cs r C - <br /> <br />^°'• E- <br />c o <br />° <br />Q <br />O <br />a <br />O <br /> U [i z cn x z 0 <br /> .?- <br />2. 11/ <br />Lf i2/1®!?'?..r <br />C l/`C ' <br />YJ.Pj"Ydl? <br />Z <br /> <br />j'j x <br /> <br /> <br />?l?` -r <br />3. <br /> <br />lY=yttJ1? 9GJc'?J? <br />0_7 <br /> <br />4' ! ?f l' <br /> <br />'(° ,R ?^ <br /> <br />2 <br />Al_ <br /> <br />??` <br /> <br />J <br /> <br />5. <br />6. <br /> R <br />7. <br />4 <br />8. <br /> v <br /> <br />9. ? <br />10. <br />Relinquished by;_._ ?-- Date: $ /Q Q Time: <br /> <br />1C. "o Received by: <br /> <br /> <br />'4 4 <br />1 <br />Date: <br />lme: <br />b D <br />IReiingilshed by: IDdic: ITttilc: 17 <br />IRecciVed b y. L-,/ {/ ITime: <br />I <br />a <br />!r <br />* Sample Reject: [ ] Return [ ] Dispose [ ] Store (30 Days)