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rs <br /> r may'„ <br /> S <br /> r� <br /> INTERNATIONAL <br /> TIECHNOLOST R/A Control No. <br /> CORPORATION CHAIN-OF-CUSTODY RECORD <br /> C/C Control No. 197897 <br /> r 4 I <br /> PROJECT NAME/NUMBER 14 41, 3'2- _ LAS DESTINATION A, <br /> SAMPLETEAM'MEMBERS 2_8_l_f-7 <br /> CARRIERIWAYBILL NO. <br /> ti <br /> Sample Sample. Date and Time Sample ContainerCondition on Receipt Dispooal <br /> Number i Location and Description Collected Type Typo (Name erx!Drte1 Record No. <br /> i <br /> �iL_4. , 01 is IJqA0QI <br /> 20 <br /> a� <br /> 11 7 <br /> �, 3 J <br /> - p <br /> -PILE 'S' 1 h — 1 U L XI- n u•; I�.S <br /> ti <br /> Special Instructions: <br /> Possible Sample Hazards: <br /> SIGNATURES:., (Name.Company,Date and Time) <br /> 1. RelinquishedBy.^ ;.,=t'' -11 3. Relinquished By: <br /> 1 } <br /> Received By:.1 i t 3- h l `. Received by: <br /> 2. Relin ulshed�e . �=-�-`" ��� '� (-� �- � •L�+,�II i ���+• ! <br /> q Y 4. Relinquished By: , <br /> Received By:l ��+J-� i`" ; ;v'`l"+�/'"�-^—' c <br /> Received By: <br /> � 4 <br /> i a <br /> WHITE-To act a:ry'r samples - ;.i <br /> _- YELLOW Fkf` <br /> - <br />