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• The Twining Laboratories, Inc. <br /> CHAIN OF CUSTODY RECORD <br /> Project No. <br /> Date/Time Sampled <br /> Affiliation of Sampler/Shipper !�J��+L�� TL <br /> Address <br /> Number Sheet City State Zip Telephone <br /> �r_/A1 <br /> � Collector's Name Signature <br /> Transported By /Z'f✓'i�'� Date Shipped / <br /> Sample Receiver �'""�"��� L'�� L✓`�G <br /> Address <br /> Date/Time deceived In 17— <br /> Comments <br /> 7 Comments <br /> . Collector's <br /> Sample No. Sample Description Analysis Requested <br /> C5, <br /> /'vo l4 /oG�S l g✓LA-S <br /> 2 � Svc►-�,o � <br /> y sem,•-�,a y.s, ' e- <br /> Chain of Possession::/�� <br /> Signal re Affilia ion Inclusive Dates <br /> 2 iliation Aff <br /> Signature Inclusive Dates <br /> 3. �- t— 1-0 -% 7 <br /> SignatureG Affiliation Inclusive Dates <br /> + 4. Signature Affiliation Inclusive Dates <br />