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.�.- ..- .. � Ate,. - t _ �` .'G•. <br /> CHAIN OF CUSTODY REgORD <br /> 'MfLE { ignaturel: <br /> -rErZ SbHuq� Applied C'eaSyste/rls <br /> Phone. _- -- 6 e-�S L 2 9c3 1 474t-E Power Inn Read,Sacramento,CA 95926 <br /> __ _ (476)4f2-2407 <br /> •Fremont •Costa Mesa •5acamento <br /> LABO ATORY: SHIPPING INFORMAT10N: <br /> Shipper <br /> 325 ObkS�td,t Vl� Address <br /> cd Dale Shipped <br /> TURNAROUND TIME: Service Used _ <br /> Attention: Airbill No. Cooisr No_ <br /> Phone No. 4-l6 els Z 240 <br /> uis by:(signatures) Received bV:(signatures) a o Time <br /> Received for labor3tery by: <br /> LABORATORY SHOULD SIGN UPON RECEIPT AND. RETURN A COPY OF THIS FORM WITH THE <br /> LABORATORY RESULTS <br /> Sample Site Date <br /> Analyses Sample Conditian <br /> No. Identliication Sampled Requested Upon Receipt <br /> a <br /> IV <br /> Tf-Mw <br /> r <br /> ��s <br />