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The leoCre.rt Group Chain_ of Custody Record . <br /> Analytical Services Request <br /> An Environmental Services Company y `7 <br /> 325 Interlocken Parkway,Suite 205•Broomfield,Colorado 80021 (enclose with each shipping container) <br /> (303)438-0970•FAX(303)438-0971 <br /> Client: J L'r>>� t/ SC c / ✓ r7 0,/> � Contact: J i ' � ,">17 ?' Address�� r�✓ �n /7 Project <br /> ect NumberA 3y39Program/She: Phone:3 do 0 : 3 1 (Collected by: c ?i These fields may be used <br /> for field test results <br /> Sample Date Sample c; =0 r Ui <br /> O <br /> Identification Sampled Time Type U u, U U v. Total <br /> f' L. ... r C /9 12 0 +rALA <br /> I <br /> 91 <br /> Condition on Receipt/Temp: <br /> Comments:et r h,G ✓ <br /> Relinquished by: — Representing: To Whom: L4,0 5 DateTme: 77777 <br /> Relinquished by: Representing: To Whom: DateTme: <br /> Relinquished by: Representing: Rec. at Lab By DateTme: �l=o y I�0 — <br /> WHITE COPY:Accompanies Samples CANARY COPY: Lab PINK CO ample <br />