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CHAIN OF CUSTODY RECORD <br /> a <br /> SAM LSR (signatAaplies GeoSYstefl <br /> 11'7. 1.11"win 31wt :uue 3 rmmnni.!.•1 44q',11 41S;hil-t <br /> phone: <br /> LABORATORY* SH'PPING INFORMATION: i <br /> Shipper <br /> Address <br /> Date Shipped <br /> TURNAROUND TIME: ? we�^S -Service Used <br /> Attention: „r� Airbiil No. Cooler No. <br /> Phone No. j <br /> Railinquiahad by: signator ) Received by:(signatures) Date Time i <br /> 1 <br /> I <br /> Roceived Or"E�taar tory by: G l <br /> ty.5'7'1�:J <br /> I ' <br /> LABORATORY SHOULD SIGN UPON RECEIPT AND RETURN A COPY OF THIS FORM WITH THE j <br /> LABORATORY RESULTS <br /> j <br /> Sample Site Date Analyses Sample Condition <br /> No. Identification Sampled Requested Ups: Receipt <br /> Q--J 7— - I-I-Q 7 T <br /> 6o- k3L <br /> y°- F-� <br /> So pa <br /> a _ Q � -8 <br /> Loo - <br /> 60 <br /> -is-�7 _ <br /> t <br />