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The Twining Laboratories, Inc. <br /> CHAIN OF CUSTODY RECORD <br /> Project No. Cl%Cs'.eo A-) ST.¢T/o '1 V' L,l7f ` 3 ToG�t 7o J fig, <br /> Date/Time Sampled /.z —fr y / . ,elti1, <br /> Affiliation of Sampler/Shipper L Ad <br /> Address ..�5_T?��.0{�:✓e ST ,C�s�c Gir ` '� 7.2/ � '�•�� <br /> Number Street City State Zip Telephone <br /> Collector's Name IPe1Y <br /> g rxgi ure �T <br /> Transported By Z_ Date Shipped 11-6�! <br /> Sample Receiver Y� �,✓i,�J � ���'�,� <br /> Address 41:;;?? <br /> Date/Time Received <br /> Comments X31Z �•,r ,ccr� .>� �.�' <br /> Collector's <br /> Sample No. Sample Description Analysis Requested <br /> l Pb) <br /> :T-,� _ <br /> Chain of Possession: <br /> Signat re ffil. tion Inclusive Dates <br /> \ p / <br /> 2. S \ <br /> Signature Affiliation <br /> Inclusive Dates <br /> 3. <br /> Signature Affiliation Inclusive Dates <br /> 4. <br /> Signature Affiliation Inclusive Dates <br />