"We, whose signatures appear below, certify that these controlled substances have been reconciled, accounted for, and destroyed at _______________(location) on _________(date) at ________o'clock."
___________________(Signature)
___________________(Signature)
___________________(Signature)
Ga. Comp. R. & Regs. R. 480-24-.06
O.C.G.A. Secs. 16-13-34, 16-13-35, 16-13-39, 16-13-72, 26-4-27, 26-4-28, 26-4-110, 26-4-113, 26-4-115.