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AQ11L r rrM r — — r —%1 r 11—err w V V■ <br /> 4665 PARIS,B-200,DENVER,CO 80239 TELEPHONE:(303)373-4772 FAX:(303)373-4791 <br /> SINCE 1906e <br /> Member of the SGS Group(SociAtA GAnArale de Surveillance) <br /> CHAIN OF CUSTODY RECORD ' r <br /> CLIENT <br /> N C Analysis Required Preservation <br /> O <br /> PROJECT NAM M N <br /> B A Remarks C Specify <br /> SAMPLER'S SIGNATURE R I or 0 Chemicals <br /> N Sample Location L Added and <br /> R E <br /> Final pH <br /> O <br /> Sample I.D. Date Time Matrix F D If known <br /> n l ��n P N 72-338877 b <br /> 72-338878 <br /> 72-338879 6 <br /> Ts S - I p l a �-� v 72-338880 b <br /> 0 <br /> 6 ,1g- g6 <br /> RELINQUISHED BY:(SIGNATURE)m DATE TIME RECEIVED BY:(SIGNATURE) RELINQUISHED BY:(SIGNATURE)® DATE TIME SHIPPED VIA: <br /> •,RELINQUISHED m DATE TIME RECEIVED BY:(SIGNATURE) REC IVED FOR LABORATORY BY: DATE TIME REMARKS: <br /> '� ( LIRE) <br /> y <br /> 'to BY:(SIGNATURE)® DATE I TIME RECEIVED BY:(SIGNATURE) �(1y� White: Remains with samples <br /> 5 r \J Distribution: Pink: Client ropy <br /> b Yellow: Labo y Copy <br />