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,,, <br /> Ail '- <br /> EST AmTest Chain of Custody Record <br /> ' 13600 NE 126th PL,Suite C, Kirkland, <br /> i Ki kl nd,WA 98034 <br /> I. a n 0 n A r o n I $ a Ph(425)885-1664. Fx(425) 820-0245 <br /> www.amtestlab.com Chain of Custody No, 5000 <br /> Client Name&Address: Invoice To: <br /> GeoDesign, Inc GeoDesign, Inc • <br /> 10700 Meridian Ave North, Suite 402 10700 Meridian Ave North, Suite 402 <br /> Seattle, WA 98133 Seattle,WA 98133 <br /> Contact Person: -Invoice Contact: <br /> Benjamin Weinberg Lisa Winship <br /> Phone No: 228-239-1153 Po Number: <br /> Fax No: Invoice Ph/Fax: 503-726-3132 <br /> E-mail: bweinberg@geodesigninc.com Invoice E-mail: geoaccounting@geodesigninc.com <br /> Report Delivery: (Choose all that apply) Data posted to online account: YES / NO <br /> Mall / Fax / Email / Posted Online Web Login ID: <br /> Special Instructions: <br /> Requested TAT; :.(Rush must be pre-approved by lab) Temperature upon Receipt: <br /> Standard RUSH ( 5 Day / 3 Day / 48 HR / 24 HR, <br /> Project Name: 1�uGutrfi Analysis Requested�� <br /> Project Number: vt, lie E c <br /> in to b a' ..\- <br /> U <br /> AmTest ID Clien ID c. <br /> ca E ' �� 0 <br /> (35 characterst max) ea 1= l o, <br /> ^ <br /> 1 ) e2-9 N'A.Iti.uw,e-c-h( LW S- -1.:Tit 1/r ` jso() so; I . ,X . <br /> Colie / elinquishe. y: ,,' :.Date _ Time ...Recei ed By: Date Time -- s°1-V.:77:,?,,,')Z.A 0:771,),_ 0;t.5 ,// . <br /> Relinquished By:. . Date Time Re <br /> 14 <br /> { sled By: �,� Data Time <br /> !fi ,,,, g /731/ 13; 50 A. I (1 L--1.. xi?3tcers i{., t <br /> ,.Rtitnquished By.j,:;/' Date Time Received By: r il Date Time <br /> COMMENTS: <br /> P.4 <br />