Laserfiche WebLink
� <br /> INTERNATIONAL lll091� <br /> EDTECHNOLOGY CHAIN-OF-CUSTODY RECORD R/A Control No. '41c.l <br /> CORPORATION 1 } C/c control No. 265175 <br /> RR <br /> PROJECTNAME/NUMBE `_JI '�-I�"�� 19Qf�,Rz ZLABDESTINATION �e� T <br /> SAMPLE TEAM MEMBERCARRIER/WAYBILL NO. <br /> Sample Sample Date and Time Sample Container Condition on Receipt Disposal <br /> Number Location and Description Collected Type Type (Name and Date) Record No. <br /> 0A r /, <br /> 13A It- -/ aA, 0. o. (2 <br /> /#A 1142 1 1 PL-0 7 /aag <br /> /f0 IIls5 ?I-C) g /�3$ a3A <br /> &A 1 171 <br /> /#A I Iz7 P�o� PLo <br /> IgA <br /> 1 <br /> 0210A 1 t <br /> a45A It II1 t 1_ <br /> Special instructions: Z4 h — —Turd <br /> Possible Sample Hazards: <br /> SIGNATURES: (Name, Company, Date and Time) <br /> 1. Relinquished By: <br /> 3. Relinquished By: <br /> Received By: L���� �� y��%� �� Received by: <br /> 2. Relinquished By: ��� / d7S54. Relinquished By: <br /> Received By: tfllg Qb 0440 OX tll5 4 °�£S Received By: <br /> WHITE-To accompany samples <br /> YELLOW-Field copy 127A-10.85 <br />