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PROJ.NO. PROJECT NAME DENVER,CO.80202-2413 <br /> J { <br /> SAMPLERS:(Signature) n j NO. <br /> OF <br /> CON. `�, •t <br /> REMARKS <br /> STAT.NO. a: in TAINERS U �� <br /> DATE TIME U ccc STATION LOCATION <br /> 11-A/ t <br /> 6 ,: (.� J % . `' ICI <br /> S i1�1L�r'I. Iflt�i / (t/V1 C V — SW — '('S <br /> it 11 rrl, IL(yI0 AA <br /> nc �(� .� <br /> ------------- <br /> J• _. 1 <br /> Relinquished by:(Signature) Date/Time Received S/by: nature \ <br /> �} y (Signature)) Rellnqulshed by:(Signature) <br /> • / ''l,( �1 ,]�", / % �: ,-^r` �. p }�., _ Date/Time Received by:(S/gnaturt <br /> ,� J //i 1•. citaC yl1c. � C,:ur '���'1�� <br /> Relinquished by:(Signature) (Date/T'� <br /> ime Received by:(Signature) <br /> Relinquished by:(Signature) Daterrlme Received by:( 9 Si nature <br /> Relinquished by:(Slgnalure) Date/Tlme Received for Laboratory by: <br /> (Signature) Dalellme Remarks <br /> Distribution:Original Accompanies shipment:First Copy to Coordinator Field Flies:second Copy to Representative of Inepecled Faclllly <br /> R8 EPA-014B (4-21.86) SpillSamples: <br /> ❑Accepted ❑ Declined <br /> Slgnetwe <br />