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u e <br /> • �n4 t <br /> The Twining Laboratories, Inc. <br /> CHAIN OF CUSTODY RECORD <br /> Project No. d-'"� SrOG G'�J S C �6 — v$-Z— G � <br /> Date Mme Sampled — (o <br /> Affiliation of Sampler/Shipper <br /> Address -Z-57Z-7 Z48--7 <br /> Number Street City State Zip Telephone <br /> Collector's Name <br /> Signature <br /> Transported By �' Date Shipped _ - g ir- <br /> Sample Receiver r <br /> Address <br /> Date/Time Received — 8 <br /> Comments <br /> Collector's <br /> Sample No. Sample Description Analysis Requested <br /> /GGA/ � ��� �/'�s�„ f,•moi„! %1/O� ��ilS p. ' �✓L a-S'L <br /> AV, <br /> .mac/'m/i4 <br /> z ' 7VCYo4 , fir''s 01 <br /> c, l 9 tar <br /> Chain of Possession: <br /> 1. % - <br /> Signat re Affili on Inclusive Dates <br /> 2. V1411 <br /> Signature )i Affiliation Inclusive Dates <br /> s. ELI -� 7 <br /> Signature Affiliation Inclusive Dates <br /> 4. <br /> Signature Affiliation Inclusive Dates <br /> s. <br />