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10500 UNIVERSITY CENTER DRIVE CHAIN-OF-CUSTODY RECORD <br /> GTEL TAMPA, FL 33812 AND ANALYSIS REQUEST 24528 <br /> r�r'olS <br /> `k( u-11iN tNc (813) 979-9092 <br /> Company Name Phone# 5l0) l -7 1 - )3?_7 <br /> Gio�nalU�t�Cr ����-.►��uf �,nc. FAX# (SIC) 49s- TV? 0 Liu <br /> Comr :iy Address Site location Lu ° x ❑a ❑ <br /> �7 �GC1 ��uC•� u <br /> � s tll�1 ' �a�l t1'�o�f,t f�lvll � 0, ❑ ❑ � a 0 <br /> Cont t sat I'nu� <br /> Project Manager Client Project ID (#) r ❑ � -a + + ❑ -J J 11( <br /> (� [ 010 0387! . 6105 <br /> C 11^1 t I/-P JOLIU co Lu Cn o o m CO co o 9 cc W O <br /> NAME E ❑ 0 ❑ a z z ❑ a ❑_ ❑ <br /> l attest that the proper field sampling Sampler Name(Print) = B ❑ in M ❑ ❑ 2 E <br /> procedure$$were used during the collection y� ` �` g ❑ m a a 0 —' o <br /> of these sLm les 1 + r a Y,k a l �iG ❑ o © a ❑o R 0. LZ 2 � d ❑ a © r W <br /> co m a m m © m m ❑ a p ❑ n <br /> Method - � o U J 0 <br /> CMatrix Preserved Sampling r N a 2 ❑ o W W w ❑ a p ❑ <br /> Field GTEL U _ ❑ a -J y ❑ <br /> Sample Lab # W 0 � �; r ❑ ❑ ❑ a a CI = <br /> o rr cis v c o o e$ w w w Oj U } �-. <br /> ID (Lab use only) a -3 p = o O w JE F- w w w = ca a a ¢ a a ¢ a 40 <br /> 3 co ¢ m a 0 = z s v o�as m m s s o o a. o- a a. <br /> W 4 Q 0. a v ¢ a <br /> W w CL w w iL w w w f- w U w O <br /> 5 zNr pl <br /> JILt a4� <br /> WERA1 (WO c OZ I I� <br /> I`FtwEE ANA 4S t Y 3S <br /> CAT -SCAU EFF R31 a� <br /> scA0 L <br /> IX 1AlY 16 co <br /> TAT Special Handling SPECIAL_ DETECTION LIMITS REMARKS (� ) U C <br /> Priority(24 hr) El GTEL Contact I <br /> Expedited(49 hr) ❑ Quote/Contract# <br /> 7 Business Da s 1:1 Confirmation# <br /> Other n r c PO# SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot# Storage Location <br /> Business Das ❑ <br /> OA 1 QC LEVEL c2 <br /> BLUE❑ CLP❑ OTHER FAX❑ Work Order# Q Z 0 2-07 <br /> Relinquished by Sampler Date Time Received by <br /> CUSTODY Relinquished by _ _ Date Time Received by. _ <br /> RECORDRelinquished by Date Time Received by Laboratory <br /> pe/94I Oa't.)7 ill 1�lt'��C�1.4�iJi <br /> Rev 71st Waybill N <br />