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GAIN OF CUSTODY RtCORD <br /> ASAL;ER (sign rs1: <br /> ;" A,00/ie4 GeoSysterrrs <br /> Phone. 1J�:; �tncnn 3hr! Stnte8 frPrrw)nt 1 ;45111 1415,E <br /> LABORATORY' SHIPPING INFORMATION : <br /> 6 Shipper <br /> Address <br /> Date Shipped <br /> TURNAROUND TIME: �,(.�lcw/< _ Service Used <br /> Attention: Alrbill No. Cooler No. <br /> Phone No. <br /> Roll uished by: (signal res) Received by:(signatures) Date 7 <br /> Receive �boratoryet,,.. <br /> LABORATORY SHOULD SIGN UPON RECEIPT AND RETURN A COPY OF THIS FORM WITH THE <br /> LABORATORY RESULTS <br /> Sample Site Date Analyses Sample Condition <br /> No. identification: Sampled Requested Upon Receipt <br /> �✓ G o,3 - - vey v- 43 T•.Ex <br /> 1 w3 <br /> r N <br /> rr� <br /> rrn ` <br /> . BQ011036 �� <br />