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; �0 %-� (ci <br /> CHAIN OF CUSTODY RECORD Phone: (800) 511-9300 <br /> Fax: (888) 445-8786 <br /> An Employee-Owned Company DATE: L I S PAGE t OF c <br /> Analysis Required <br /> Project Manager: <br /> Project Name: } Email: <br /> m o-+1 v (CJ GCC <br /> Client: Sampler: )_ c <br /> L <br /> Address/Location: .v t, ` Lab Project No.: <br /> Sample 1ID/Location/Description Date Time/ Matrix # Notes <br /> Relinquished by Date: Time: Laboratory: <br /> Courier. Received by: Date: Time: <br /> Relinquished by: Date: Time: Rereiy_�dby: Date: Time: <br /> !� 6 26 if--20 /o/,�l I5 <br /> Relinquished by. Date: Time: Received by: Date: Time: <br /> Requested Turn Around Time: 24 hours 48 hours 72 hours 5 days Other: iL Matrix Codes: A=Air W=Water S=Solid <br /> .J r <br /> Special Instructions to lab: Global ID: Authorized Signature: <br /> Pauc 7 of'S <br />