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Chain-of-Custody Record �,. 1359 <br /> r1 Date <br /> P JA[t NO.: 3077 ANALYSES REMARKS <br /> --- <br /> sa piers(signatures, Additional Comments <br /> t v o o IQAPP,OA samples,ekc.) --- <br /> o <br /> 0 CO CO OD COs <br /> o d O O b <br /> M n G D <br /> 2 o <br /> Date Time Sample Number Nw Ui U1 LU a F a D <br /> V 1i Q Z <br /> p .Qj r <br /> - 7 � I <br /> 1' t Si��4 ;JtV)F <br /> �Ser •cc.z S _ <br /> 5 g1'1 Cu <br /> Gp{i-007 J <br /> Turnaround tlme: Results to: Total No.of containers: <br /> �T C!N,..•/3ri.�.� f H••C.(.� J/ L C r F l !fir.•/.1 ---- li <br /> Relln Is y i5 ature): Date: IIn I by(signature): Date: Relinquished by(signature): Date: Method of Shipment: <br /> -9 1 Ii �s (__)v•t� <br /> .t — <br /> Print a e: ) rl ed Name: Printed Name: Laboratory Comments and tog No.: <br /> Time: Time: Time: <br /> 'Sit— <br /> Company,. <br /> It--,Company: Company: f � Company: <br /> Recelature): Date: Receive tslgnat Date: Received by(signature): Date: <br /> PrintedtNa e: Printed Na e: 6Printed Name: Geommtrix Consultnwits <br /> r, i1a P9tt.l Time: 1 , xt��l`fii Time: Time. 2444 r.nainStre!L+t,skit(.2115 <br /> Frc:4r.n.Calilarr,in:33721-2?;awl <br /> Company: 11,,q Company: l f�3� any: W09I 264-25AN /ywJ I2O4]284-74tion: ellonto k— or — <br />