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;U61 Feuvral Ave.. Los Angeles, CA 94064 <br /> Phone: (213)478-4050 Fax: (210)478-8004 <br /> Laboratory Chain of Custody Record `p c c <br /> Job No.: <br /> Client: 0 <br /> r <br /> Contact: Phone: <br /> Address: t <<s 1)r' - - Fax: 21L1 / r ' <br /> A <br /> r C Anal ses <br /> Project: cJ I r <br /> Remarks: <br /> Lair ID field ID ! DatefTime Bottle No. Pmerv. Matrix � Comments <br /> Tyee <br /> 4,lo <br /> ` F <br /> �I <br /> EE1 <br /> Relinquished: rC Daterrime: e' • S`) Received by: <br /> Relinquished: Date/Time: Received by: <br /> Fielinquishod: l7atelTimo: Received by; __ <br />