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�. ANALYSIS RE A <br /> TWHN CHAIN OF CUSTODY CORD Page 1 o <br /> CORPORATION <br /> d � <br /> Project Name/No 1 �'`"' Samples Shipment Date 7 Bill to 5 Cb t �9J <br /> ample Team Members Lab Destination a JD(r4 C� <br /> Profit Center No. 3 Lab Contact ill � <br /> Project Manager �_ t✓15 D^� Project Contact/Phone 33 Report to*10 ��v+•-� '�� Q tD <br /> Purchase Order No <br /> s %64'39?r' Carrier/Waybill No 13 <br /> 3 <br /> Required Report Date 11 a • m <br /> M <br /> Sample 14 Sample 15 Date/Time 16 Container ample 1 Pro. 19 Requested Testing 20 Candrtion an 21 Dispeeai 22 <br /> Number Dae T Volume servative program Recei t Record No. <br /> �r �� T <br /> CL <br /> 0 <br /> 0 <br /> %ff maw am 110W on m ro <br /> Cr <br /> n <br /> SL <br /> S ectal Instructions. <br /> 23 Sample Disposal. 25 <br /> Possible H and Identification• 24 P P <br /> Return to Client Disposal by Lab Archive—_..�— [mos ) <br /> Non-hazard Flammable Ul Skin Irritant Poison B Unknownm <br /> Turner nd Time Required: zs C Le��[�27 Ill� pro act Specific i3 act <br /> Normal Rush�lJJ3Date_ <br /> 1 Relinquished Date L da 11. Received by 28 <br /> Time* Y a <br /> 1Jffr17 <br /> Reli (juish .�- &It � Time tsgnap,re�Affdiadoni <br /> Date 2 Received by Date.— <br /> nquished by Tme l5ire�nirerjonl Time <br /> Data 3 Received by - DateTimeinquished by Time. <br /> (Swowre/Affifiawl <br /> Comments 29 <br />