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993 CHAIN OF CUSTODY RECORD I ANALYTICAL SERVICES AGREEMENT Page of <br />?LC L ({,r C?s? <br />Mail Original Report to: Mail Invoice to: <br />Attn: W I L 14 ?' S 121 F Attn: <br />Address: Address: <br />CitylStatelZip: CltylStatelZlp: <br />Telephone 0: Fax*: Telephone 0: Fax 4: <br />Email: Project ID S: <br />P.O.0: Quote 8 <br />Report also by Fax POF EDD 0 Sampler: <br />Standard 10 working days Yes No <br />UST Analyses per Fee Schedule Yes No <br />Report chromatograms Yes No Report Results by: (date)"" <br />Evergreen Analytical Laboratory MATRIX ANALYSES Rush Turn Around Time <br />4036 Youngfield Street <br />Colorado 80033 <br />Wheat Rid <br />e <br />3 l <br />y <br />" Subject to surcharge a <br />g <br />, <br />1 ` ? in tee <br />? <br />(303) 425.802 N ecltedul <br />FAX (303) 425-6854 <br />' <br />(877) 7374521 less than 24 hro, +15096• <br />e-mail infooevergreenanalytical.com 1 -2 workdays, +10096' <br />H <br /> c m 3 .? 1 y? 3 -5 work days, +50% <br />0 <br />k d <br />+25% <br />e <br />NOTE: Identify Known Hazards Below w g, L g •o - <br />wor <br />ays, <br /> <br />FI <br />T _ • Not all tests are available for <br />this TAT <br />' <br />CATION SAMPLED TIME <br />IDEN <br />I Z 0 (s? <br /> <br /> <br />C S ,,1r?, 1 1 14 u ..:.:, . <br /> <br /> <br /> ~ ... <br /> <br /> :ON' c <br /> <br /> y 4., <br />Sam Is Fraction S, td Yn1 1? G ?' <br />, <br />Loo <br />Instructions: <br />Anions (check): Nitrate ?Nitrke Chloride ?Sulfate ?Bromide ?O-Phosphate Fluoride <br />Relinquished by: (Signature) <br />••••, <br /> <br />' DatelTime Received by: (Signature) <br /> <br />/ - <br />• <br />? DatelTime <br />/1 C./(/d <br />For Liratory pn <br />Yx NA a- <br />w .*?ZS,3? 8?a1? v x <br />" <br /> t? ??- t <br />p <br />" <br /> les Pressrvad ,, YJI?tNK <br />i !14 3 3sm <br />10 ilk +2 <br />Relinquish y: (Signature) Datamme Received by: ipnaturo) Datelrme CJ8 (0) Hestpa0e k <br /> loeI " <br />C/8 (I)` <br />, <br /> ( <br />9y <br />TempC -vrT <br />1 1111 111112 m im M M M M M M M I= on M = M M M