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DATE/TIME_ <br />CLIENT_ <br />CLIENT SERVICES REP_ <br />PROBLEM CHAIN -OF -CUSTODY �k Q .4 �ZZO <br />b I�1 2oy DATE RECEIVED 30010-7 <br />4�R TURN AROUND TIME to <br />Q . ANALYST Q .y - <br />A.',,.,, ? <br />PROBLEM <br />Client Contact for Instruction: X//A <br />Date and Time of Instruction: <br />Date & Time Form Given t� Sample Control: ; 7L 7 �•r3`� <br />CLIENT SERVICES REP. IGNATURE: <br />ATE/ IME: */7107 <br />1f client does not ret�rn call within 24 hours, please route this form to the Laboratory Director, <br />White Copy - Cli ant Services <br />Pink Copy - Sample Control <br /><, �- <br />Yk�i.�:: <br />lk iyji F.I0*.tk �.E ':-„Y15 <br />Client Instruction” <br />�EE-g{ �,E�� �'+:�.-,�- <br />.3'^v'. <br />RESOLUTION <br />Telephone Number of Client: <br />Client Contact for Instruction: X//A <br />Date and Time of Instruction: <br />Date & Time Form Given t� Sample Control: ; 7L 7 �•r3`� <br />CLIENT SERVICES REP. IGNATURE: <br />ATE/ IME: */7107 <br />1f client does not ret�rn call within 24 hours, please route this form to the Laboratory Director, <br />White Copy - Cli ant Services <br />Pink Copy - Sample Control <br />