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IcE lC-s~ i// �� �,, �) <br /> c N7c� .oNt/) r7^v r Iii;--er.)E <br /> The Twining Laboratories, Inc. <br /> " CHAIN OF CUSTODY RECORD <br /> Project No. I AC I TA5 SSI t� L (IG' �tt ilx �f iv f� . 1J,10 <br /> Date IT!meSampled — % I / J — C) 'tt <br /> Affiliation of Sampler/Shipper '!JC <br /> Address 14C S Gp&jl7g b/ 44 /�'�0�3� ��7T / j S� t;9 <br /> Number Street City state Zip Telephone <br /> 'r <br /> Collector's Name )LY'l (,,,, <br /> v Signature V F <br /> Transported By �T�/ Ir/Nl7 Date Shipped y {U�I <br /> Sample Receiver q 9 <br /> Address <br /> ENVIRONM AITI <br /> Date/Time Received PERMITISERVICES <br /> , <br /> Comments 7 yj9 7 J <br /> Collector's <br /> Sample No. ample Description 'O1 Analysis Requested friD <br /> Z' YiF�oyv"P�oDI�GYL,n/F �Sr Lt><A7rUrJ <br /> W w5-5r9ivF OF �Acr>' ' TP9� x F rFL <br /> _ L Zr '6E'�.Oul tH7JG>LrNEs I"AS�/1:L�}r70n/ v i .' <br /> rN�>> i0� n(- i,111 FtIEL�rCi' .�SE yrT51<nlD j <br />' ;-•t=rNr�FS>i'o�tif�oF iI}Ntt Er.*{v�nn/ <br /> 9 t=ReA AC. 4ADF- 7.7 '6Euu/ loP)FRA4-,S/J!8 <br /> ' !tM(«`fE T(UY Gj— r lett ,_ri:>(;i/rani �• -- 1.-•.�.1 <br /> �V ✓� — �YZr ;F. iir,t C,r_-imkIF . �_�l�'E�s�,+li�i�i <br /> C -- SOtJ77 t( J�rYEY- </ H�S�x«jv V'id _ <br /> r7- 1)r}DF, �f//tNKJ"M <br /> 50LOlt '' '9FYv_ Jr`-1. r: rYCrIYTri/VN <br /> Ckain of Possession' <br /> Signature Affiliation Inclusive Dates <br /> 2. <br /> Signature Affiliation Inclusive Dates <br /> 3. i�l 'V,'I lin. ` p " !l j!':^. A - <br /> `1 <br /> j Signature Affiliation Inclusive Dates <br /> 4. l <br /> Signature Affiliation Inclusive Dates <br />