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SunStar Laboratories, Inc. Chain of Custody Record <br /> 25712 Commercentre Dr <br /> Lake Forest, CA 92630 <br /> 949-29"77--502{0 f <br /> Client: 1Ctd�'1'1jg;v/ EoaC -ymeeNjkllI I&5j—JHCl) InG . Date: /rtlJY11 'Ly , Z/���1�Ifi� Pag�e+rr: F� L of 7n <br /> Project Name:-L[407- 5CA)11 V'WIGt�'t"tr a- �-f�Gk'f'ON �i•'l 95 6 <br /> Address: - 1 f- t <br /> Phone: Fax: Collector: g . le-f M Client Project <br /> Project Manager: Gl W,1/1 S - .Batch#: `T °`�-`l�• EDF#: - <br /> c w t) <br /> T s N <br /> C U <br /> p <br /> O o m U ❑ a <br /> © X X x <br /> W W Or 'p O {� r p d <br /> r� O m e] o °S i0 Yk <br /> SampleContainer N "' 'p "' o (� <br /> Sample ID Date Sample Time Type Type m Omco <br /> m V Comments/Preservative I-p- <br /> l-S 2oiq 8'4sf -I e, X X �. <br /> oz <br /> BZ 5 a0 6 <br /> 13z-IO <br /> B3-5- <br /> b <br /> 63-to .�. on.. 5 <br /> 67- 157 ?iM+ ° <br /> at. b <br /> • ® 1p$ d+ Dti <br /> S' 0=Q o" 1 0 <br /> S-to if at T1 P- ti' <br /> O'31&- t <br /> 6E-<0 a= 1N <br /> _ 01q is <br /> nature) ,+` D e/Time Reoeiv by:( ' (Date/Time / 7-. Total#of containers Notes - <br /> 7/Zq T�+R{ -1V �` �-/ - Aain of Custody seal !NA - <br /> Rellnq by!(signature) - Date/Time Recei d b Date/Ti a Seals intact?/ /NA ®-„ <br /> GS0 u 1asltI4 £CSa � ZS /y PSo Received good condition/cold b 7 � � <br /> Relinquished by:(signature) Date/Time Received by (signature) at /Time -( <br /> Turn around time: I , - <br /> Sample disposal Instructions: Disposal @$2.00 each Return to client Pickup <br /> COC135500 <br />