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OVALITY ANALYTICAL LABORATORIES CHAIN OF CUSTODY RECORD AND AGREEMENT TO PERFORM SERVICES 2045 <br /> CH211f HILL Project! Purchase Order x LAB TEST CODES <br /> SLIM {f` 502107 � ,, I y •+ - <br /> Project Name <br /> t.:L-I"ENr: CH2 <br /> # DUB. 02/09/95 <br /> Company Name1CH2M HILL Office REF 0:20431 �� 4 <br /> O Y . . <br /> F I ` ' <br /> Pro)ac�Aaneger a Phone* Report Copy to: ANALYSES REQUESTED4 yhYr <br /> Ms.[ ] C <br /> Dr. O w <br /> Requested Completion Date: Sampling RequlreE ee Sample Disposal: N <br /> Dispose Return T <br /> SDWA NPDES F MA O17tER P A F <br /> El El 0 El El <br /> Type Matrix . <br /> Sampling C G W S CLIENT SAMPLE ID R <br /> M A T IO (9 CHARACTERS) $ - <br /> � . <br /> Date Time P B RE L I REMARKS <br /> W1_;_ 1V Rio -62...... <br /> I - <br /> SO ted By t; I +wnaad Dae me Rell ed B > D meyjjpAp r y v� :. <br /> �f a.L;'. <br /> Received By datemme elinquished By (Pbees sign&W print name) DateMme ac.,,L *M.J, ''t�tlrer•_ <br /> L - COO Ree,. ;Kms: , <br /> Received By <br /> 11RIOMWIgnandprinlanw) DateMine Relinquished By (pieaaasign and print name) Datemme Ani <br /> Re4 <br /> CUM S" , Ph - <br /> Received By (P6oa sign ind prim.M. Datemme Shipped ilia Shipping#� <br /> UPS 'BUS Fed-Ex Hand Othez <br /> Work Authorized By Iprn.+gnam p"ne"): Remarks <br /> Instructions and Agreement Provisions on Reverse Side n►srRreunoN:oRrcfNac-rimae,relraav-LAB,Pink�-Cflenf <br /> REV 11192 FORM W <br />