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CHAL .` OF CUSTODY RECO. �Q <br /> -- <br /> =,�AEIA (signature); � �----- <br /> �,o/3/i�d G�oSysfems <br /> Phone: �f�� ��T �j?i5 1115�I-?n Bkil Su,fe13 Firmanf.C'A U4511! J415i651-14f11, <br /> LABORATORY: SHIPPING INFORMATION: <br /> b �rL OS S h i <br /> - - Pper <br /> Address <br /> _ .._ Date Shipped <br /> TURNAROUND TIME: 2-+-t �{vv2 5 Service Used <br /> Praiec! Leudar: KG/Y4 AQ A-1 r* b Alrbill No. Cooler Flo, <br /> Phone No. [1 14J V S-7-_:s4p <br /> Reli fished ay:(signatures) Received by:lsignatures) Date Time <br /> Receive_"r laboratory by: <br /> lrv�� s7- P Fy <br /> _,ABOAATORY SHOULD SIGN UPON RECEIPT AND RETURN A COPY OF THIS FORM WITH THE <br /> LABORATORY RESULTS <br /> Sample Site Date Analyses Ssmpfe Condition <br /> No. Identification Sampled Requested Upon Receipt <br /> s�y—41.rvG 3 \` <br /> S-Lf-L.Fs -� <br /> 7 w � <br /> 1 ` <br /> 7 <br /> vSSfS/3 i,� I ' <br /> R <br /> S �u5i3 —1B <br /> --------- <br /> ---------------------- <br />