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;ustomerlD : 00009830 n <br />Collected: I <br />month d <br />n n <br />day y <br />year h <br />n 0 <br />I Time o <br />hour m <br />0 0 <br />min <br />0 a.m <br />CUSTOMER <br />Colorado Dcparvnent <br />of Public Health <br />and Environment <br />Laboratory Services Division <br />8100 Lowry Boulevard, Denver, CO <br />US Mail: PO Box 17123, Denver, C( <br />(303) 3090 fax (303) 344 -99 <br />REQUEST FOR ANALYTICAL SErtvit,co <br />LSD Interent Address: http:// www .cdphe.state.co.us /Ir /lrhom.htm Report #250Req <br />System ID ENV - 2011007890 <br />Collection Date 1/1/1900 12:00:OOAM <br />Control Number 30 <br />L_l LJ LJ <br />SPECIMEN INFORMATION <br />