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cw6gkof re� i� c 0312425 Page of L g <br /> 1101 71h Street <br /> L{�xlrs(o-CA Chain of Custody <br /> (2091.522-at 191 Fax 522.4227 <br /> E-mail: Analysis Requested Name and Address, <br /> Project11: CI er;'Project Name- <br /> Site AWr"s: ^� <br /> Remarks. Lab Purchase Order JF' <br /> c <br /> SampI d ;tprF and sgi rarre) i Turraround Mine: - nda•d _J ASAP <br /> 6 x J 24 Hbu r Q 01her <br /> Date Time Sample I.D. z Z Remarks <br /> nJ t. <br /> Reli 1 sMi� ' ' al Date: 7i naf R bti" . � b iry � Da Tirna: 0 D <br /> L L <br /> He1i')qul5hed hy. "Sigr1Fzjr9_r Data: Ti,m&: Received cy- (!i; atura) Date: T r-ie_ <br /> ReJ'nqushed oy:;sgnalurc' Data: Tim: Received Ly. (si rr�lirei Date: Time: <br /> Please return coolerAcle chest to Geological Technics Inc. <br />