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2010-06-09_HYDROLOGY - M1977300
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2010-06-09_HYDROLOGY - M1977300
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Entry Properties
Last modified
8/24/2016 4:12:54 PM
Creation date
7/2/2010 7:59:32 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1977300
IBM Index Class Name
HYDROLOGY
Doc Date
6/9/2010
Doc Name
Analytical Results
From
Analytica Environmental Laboratories
To
DRMS
Permit Index Doc Type
Hydrology Report
Email Name
DB2
Media Type
D
Archive
No
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Analytica Chain of Custody Form <br />12189 Pennsylvania St. 4307 Arctic Boulevard 475 Hall St. 5438 Shaune Drive <br />Thornton, CO 80241 Anchorage, AK 99503 Pairbanks, AK 99701 Juneau, AK 99801 <br />A <br />ANALYTICA (303) 469-8868 (907) 258.2155 (907) 456 - 3116 (907) 780.6668 <br />(303) 469.5254 fax (907) 25&6634 fax (907) 456-3125 Fax (907) 780-8670 fax <br />Page L of <br />Chain of Custody No: 7 4 1 0 5 <br />GRGVPap <br /> <br />Client Name & Address: <br /> <br />Public Water System (PWS) ID#: <br />Af <br /> <br /> <br />- <br />1 <br />S;w- ?I- I <br />oo -W 7410t Project Name: l..r1 q77 30 0 Quote ID: LGN' <br />f 1005139 <br /> <br />- <br />c Account ??: Cash . Credit Card F M <br />Report to: bav;'k '81 r • Invoice to Name & Address:: <br />Phone No' Standard Expedited (<:odm, Mwau ,rnimuonrewt*) S_eP f q ? <br />/ <br />+ <br />No: <br />Fax °""ea J yea i W.W. <br />?'1 Q' <br />Cr <br />Ct7 <br />E-mail: Requested Due Date for Results: <br />Special Instructions/Comments: <br /> <br />Kit Prepl$hipping Charge: $ <br /> <br /> <br />Client Sample Identification ! Location <br /> <br /> <br /> <br />ate <br />Sampled <br /> <br /> <br /> <br />ime <br />Sampled <br /> <br />t c <br />o <br /> <br />g o <br /> <br />z° <br /> <br />v <br />?.. <br /> <br />?? P.O, or Contract No: <br />Requested Analysis/Method <br />1 - <br />I <br /> <br />g <br /> <br />@ <br /> <br />a <br /> <br />r° <br /> <br />d <br /> <br />3 <br /> <br />d <br />u <br /> <br />y <br /> <br />w <br /> 1530 m? 3 X <br /> <br />p©T U T ? 47- l o 150 NO k x 1V <br />OTW - A. 1 ? L. tt `ss It 4 X x K x y / <br />o`W -low-4/ It 16-01 .? K x x A/ <br />temp -1 j 511?11 n la: So r+ i X <br />Filt-cr <br /> <br /> <br /> <br />Re n ish b _y' Date Time Received b)[. te <br />D Time <br /> fd ? <br />«? a <br />?1 s S Condition of THO ANC JNU FBKS <br />Relin wished b : Date Time Received . Date Time Custody Seal?: <br /> Initialed ay: <br />Relinquished b : Date Time Received b : Date Time Temp/Loc: <br /> a I <br />Thermo ID#; <br />. <br />Name of Sampler. (printed) l z <br />I Shipped \Ma: <br /> <br />Version 2.0
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