NCS000173 DMR SW (2)

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Analytical & Consulting Chemists
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ENVIRONMENTAL CHEMISTS, INC
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: OLS CERTIFICATION # 37729
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6602 Windmill Way Wilmington, NC 28405
OFFICE: 910-392-0223 FAX [phone]
[e-mail]
CLIENT: N
PROJECT NAME: C�5 M L
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REPORT NO: 3 —1 0
ADDRESS: Z
CONTACT NAME: Mf ""
PO NO:
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REPORT TO:
PHONE/FAX: 5 f S7.- �
COPY TO:
email: l
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Sampled 5sAMI'Lt I Trt: I = inriueni,
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t = r.n►uem, yr — rrGu, %JI — OL V 11, .a%,,Y,
Sample Identification
Collectiona
y F
y
E `o o`o
v V --
J
L a
v
c w
g?
z
PRESERVATION
ANALYSIS REQUESTED
Date Time
Temp
o
z
x
0
=
z
x
o
o_
iE
jE
o
3Q> (
zl
SSR j
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x
OFF,
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G G
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G G
C P
G G
CP
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G G
Transfer Relinquished By: Date/Time
Received By. Date/Time
'f.
2.
Temperature when Received: ceptea:---V_
Delivered By: 5611noW -t- a& --M ' e Received
.
mesampie Meques>;ea:
_Date: Q SoCc.,13 Time: O : C0
TURNAROUND: 57RAVAkVi