IGMY D - Hanford Site

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CHAIN OF CUSTODY/SAMPLE ANALYSIS REQUEST
C/
107-006-312
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Page 1 of 1
Collector atael/Reeawer feleohote Na MSLY FAX
FNa Saaee11 (k41a PorTbaat OrdnHAarte Code
Freled TM
1^^ ^ !f / .Z
to Cbal No. n Tema
lCh"IfIRMAW1121-1 01 NovEmnrR 2("
Wooed To Mb) Method of sbiomeat (^U
Bi ll of iwUa/Alr &R Na
Protocol
POSSIBLE SAMPLE t1A 7ARDSIRLMARKS
« « Coaad Radkadae tdaltdd at emewMion dot are tottetdaad Re lnmpatrim po e9 CFR but are sot
mimrb6 pet DDB Gear 5{00.5(1990(1997)
Prlaity: 0(5 Lays
U(fdte Proeerty No.
SPECL41, LYSTRUCfIONS 1Wd Time Total Activity F xemdim: Yu h1l No
AalaWeaorp1WSCF:Baeb aRFNNL"ki sdatimdmadrtA. 4LS.WW07SAfs iWone SDG.temmeaotedSDO
cl a of le aya .
WSCP: DakYa ll PNNL GIN mWks eebm ised aw owe SD G. da ily*soa
Sample No. Lab R) • Dale Titre No/Type (:ontainer Sanplc Analys is Preservative
B1KYR5 (F) W 1MG-ml. aGV COLOR TK_FLD: tlexavelenl Chromium (1) None
I^
Red Dedlime W7 Raccinday ttyo Do wrino Mabia •
NOV 7 1 700fi NOV 7 1 7w 135f R . Ri , - rwe wn
RR - sat'ema r at.
RetiagitiJedBy Dwdf® Remived Oy Dae7ima
- A.malial
90 - wia T — T.eoe
' M. - SA.1ra wl - Wine
W - w.v r. - TkM
RdbgtattedayDaNraw, Raeied By Da rises,
G - ( a
Y - V- tka,
A - Air x - Oda
RdWgWsWdBy Datdlim Received By DOWNT"
F7NAL SAMPLE Dkf*Wme" ('11. 1. his pmpd.e, ea:di pectem) Diepowd By Datdlima
I N cC;030 r- / - 3D
M
0
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