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s <br /> r� <br /> r The Twining Laboratories, Inc. <br /> CHAIN OF CUSTODY RECORD <br /> Project No. <br /> Date/Time Sampled // <br /> Affiliation of Sampler/Shipper i.Vc <br /> Address -2S-?7 F.e<svo 5T F.rlsA,161 - C A 9�>,z/ <br /> Number Street City State Zip Telephone <br /> Collector's Name Q��.. �1 cr �scr,.r I <br /> (� Signature" <br /> Transported By Date Shipped <br /> Sample Receiver ''7w,wi,yG L,4 FS i.Jc <br /> Address 25'.1.7 F.«s vo .5 7' <br /> Date/Time Received .3 <br /> Comments 2n <br /> Collector's <br /> Sample No. Sample Description Analysis Requested <br /> 11aZ e Jl/ -c e,vre-,c le <br /> Chain of Possession: <br /> Sfgtiatur ' _ Affiliation_ Inclusive Dates <br /> 2. <br /> ign'at -7� Affiliation Inclusive Dates <br /> 3. <br /> nature Affiliation Inclusive Dates <br /> Signature Affiliation Inclusive D;tes <br />