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LAM IMIb MM RA%n&MocM%n1"V <br /> COW4TRAnoN CHAIN OF GUSTO ECORD Page 1 of _J_ , <br /> Protect Name/No. 1 DSS I,� Samples Shipment Data 7 2- /3 oa Bio to 5 - T eeIf <br /> ample Tears Members 2 _ Lab Destination a �a-DoA _ /4,-73 A) �9If� <br /> Profit Center No. <br /> 3 SC. Lab Contacts __ n _ _ 4',_ __o <br /> Project Managers 'TDM � 11#A Project Contact/Phone t2 `3387 Report to.10 Si^e ids /l To <br /> Purchase Order No.s fl o�L3 Camer/Waybill No. 13 <br /> Required Report Date 11 <br /> t4 15 16 1 lel %W19 ueeted T 20 Gond on on 21 nispo"l 22 <br /> Sample Semple Dow/Tima ca�hw' Votumma �nradnr �0 t4 <br /> Number n Call 0r w Aecor No. <br /> 1 Q oqCL <br /> 55 319n <br /> En <br /> Cr <br /> n <br /> Special Instruct+ons 23 isposal: Cr <br /> Possible H and Identification: 2a Sample D0 <br /> No"azard Flammable Skin Imtant ❑ Poison B ❑ Unknown [JIReturn to Client❑ Oisposa!b11 Lib Ar'chtve__._____ (mos.] <br /> • <br /> Turns�nTime Required: 26 Lever 27 <br /> NormalZrr Rush❑ H Ill Q Pro ect Reeffic eco <br /> 1 Relinquished Date- 0V 1. Received by :27--A& 7at7e <br /> tft,,.wr.iwer.aonl � <br /> Time, Z ts�"/Affia�,t <br /> 2. Relinquished Date: 2. Received by <br /> �.�usrt Time: .a/, reaa,1 <br /> 3. Relinquished by Date: 3. Received by <br /> ftnewm/A ir�,l Time: d�^! <br /> Comments:29 �� <br />