310095_Other_20181004

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Analytical & Consulting Chemists
Client: NCDC-kj P C
'Samr)led Bv: /'?;�, �d �►-o�l�,,,
ENVIRONMENTAL CHEMISTS, I N C mington, NC 28405
6602 I E: 910-392-02231FAX [phone],
NCDENR: DWQ CERTIFICATION # % NCDHHS: DLS CERTIFICATION # 37729 - [e-mail]
COLLECTION AND CHAIN OF CUSTODY
PROJECT NAME: 3 (REPORT,NO:
CONTACT NAME: PO NO:
REPORT.TO: PHONEIFAX:
COPY TO: ' - email: IVC49el(
CAU101 G 7•VOG. 1 1�..__a r _
Sample Identfication
Collection
a0
1 F
s
p a
E° 0
cf7
c°
�J
L E
"
W
g
z
PRESERVATION
71.1 WOFF11
.7V 01011, aL = sluage, ether.
ANALYSIS, REQUESTED
Date
-
Time
Temp"
i
=
_
0
_"
0
_
0
_
o
w
o
C
..
I �l�
31c�
G
G
lo•
3
�e�
C92
G
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G I
G
C
P
G
G
` Transfer
Relinquished By-
_1196eiv-W
Date/Time
�i
/DateMmey
2.
1 ClnNrraau"! wntan 1[t3GC1Vt.'u. "� ACCepieu: " K ea: Resample Re ^ need:
Delivered By: Received By: Date: I0 �`( 25 Time:
Coinm�ts: TURNAROUND: