APPLIED CONSUMER SERVICES, INC.
11890 N.W. 87 COURT, UNIT #8, HIALEAH GARDENS, FL 33018 
Phone: (305) 821-1677   Fax: (305) 821-0155   E-Mail: info@appliedconsumer.com

 

 

     SAMPLE RECEIPT / CHAIN OF CUSTODY

 

 

Samples received on the ___________day of ___________, 20_______.

 

 

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Received by: ________________________  Date: _______________

 

Delivered by: ________________________ Date: _______________

 

Witnessed by: _______________________ Date: _______________