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i1• w iw w w w w w w iliw ' w w w w w w w iiiiw --- <br /> SunStar Laboratories, Inc. <br /> 3002 Dow Ave., Ste. 212 Chain of Custody Record <br /> Tustin, CA 92780 <br /> 714-505-4010 <br /> Client: Date: aliiii Page:_Of <br /> Address:4703 •1'C 11yF-. _� AIDC lL l�� D CA +JW( Project Name: '' ' S��1�Yh VL�i e ��✓T <br /> Phone: di 10 q'31—q2.e),o Fax: Teo 76 715 Collector: T Client Project#: 661r-80004 <br /> Project Manager: FgZAw2IC Po1�P3 Batch#: TMXY6 COC <br /> 71855 I <br /> i <br /> � q <br /> C t d <br /> C <br /> mm N C <br /> XX C W d 0 <br /> D y F O <br /> d U <br /> Q f D W 8 y O o <br /> + m m C SV�I rp yi <br /> Sample Container .� o N N n •n o_ <br /> j <br /> Sample ID Date Sample Time Type Type m Comments/Preservative F <br /> i - <br /> - 4501 L /O -/b <br /> O.Or <br /> &.11111LA&MT MY- <br /> -1 O11 IX <br /> Z .O 9 tIC5 <br /> O:o <br /> t Ol.'Z a <br /> t ' Vow <br /> Lt t= <br /> I <br /> Rel s Date/Time Received by:(signature) Date/Time Total#of containers 13 Notes <br /> t`/Zs <br /> / 101F(.J Chain of Custody seals V/Nll®1 <br /> Relin Ished by:(signature) Date/Time Rece' ad by:(signature) Date/Time Seals intact?y/Nq& <br /> Received good conditlon/col Xi <br /> Relinquished by:(signature) Date/Time Reeeived by:(signature) Date/Time /-Mi -n <br /> Turn around time; <br /> Sample disposal Instructions: Disposal Q$2.00 each Return to client Pickup n'�,J 111 111 <br />