NCS000174 DMR SW - Not On Required DMR Form

Analocal & Consulting Chemists
ENVIRONMENTAL CHEMISTS, INC
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729
COLLECTION AND CHAIN OF CUSTODY
6602 Windmill Way Wilmington, NC 28405
OFFICE: 910-392-0223 FAX [phone]
[e-mail]
Pme l a ' 2
CLIENT:
PROJECT NAME: 1\I CA
REPORT NO: -�
ADDRESS: O
CONTACT NAME:
PO NO: jZ
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REPORT TO: r
PHONE/FAX: S2- S$6
COPY TO:
email:
Sampled Bv: h IMliV21 -rA u-NEOX SAMPLE TYPE: I = Influent. E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Ideniffication
PRESERVATION
ANALYSIS REQUESTED
IL
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Received By:�.
Temperature when Received: Accepted: Resample Requested:
Delivered By: Received By: R jec d: Date: ZZNaoS Time:
Comments: TURNAROUND: M

Analytical & Consulting Chemists
ENVIRONMENTAL CHEMISTS, INC
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729
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6602 Windmill Way Wilmington, NC 28405
OFFICE: 910-392-0223 FAX [phone]
[e-mail]
CLIENT: i`>.�1
PROJECT NAME: M v„S„ Y, _�bW__. _...
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REPORT NO: t3 �} loS
ADDRESS: Z -o oLD Vh&t V4Q
CONTACT NAME:
PO NO:
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REPORT TO:
PHONE/FAX:
ANALYSIS REQUESTED
COPY TO:
email:
Qmmnlerl Ru. SAMPLE TYPE: I = Influent. E = Effluent. W = Well. ST = Stream, SO = Soil, SL = Sludge, Other:
I
Sample Identification
Collection
ANALYSIS REQUESTED
By: Received By:
-Relinquished
Temperature when Received: Accepted: ej ct Resample Requested:
Delivered By: �lhAr&I � Received By: �AzQ Date: 7--wai1-I Time:
Comments: �� TURNAROUND: "