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SunStarL ratones`, Inc Chain of Cu dy Record Y <br /> 326 Encinitas Blvd, Ste 150 <br /> Encinitas, CA 92024 <br /> 1-500-900-9333 r <br /> Client, S I've' _ - F bate -21.L)3 Page . f Of= <br /> ry _ <br /> Address Ili 7 ,r 4 X11 k r,,v r"-_ � Protect Name F: A k �L"�_'� — <br /> PhoneCollector'Fax 't 2s Client Protec #t � <br /> Protect Manager 5 _ 1 l3atch# ` Proposal# <br /> L t <br /> N <br /> V N <br /> N <br /> C .. V 9 <br /> 75 CD <br /> rn o o <br /> 0 <br /> F N Coo O Y LO O O 0 O <br /> a 00 CIDCO Co Fri CO CO W ((a <br /> Sample Container ¢ Q ¢ a I3 Q ¢ ¢ Q <br /> Sample Ill Date Sampled Time Type, rType w w w w w w w w w ci Comments <br /> r* ? g <br /> &A04 Cel. <br /> r - X111"A 7MIMA L <br /> ' r <br /> f <br /> r <br /> x � <br /> I _ <br /> Relinquished by (signature)' Date 1 Time Received by (signature) Date 1 Time Total#of containers Notes <br /> ^ • , - ; Cham of Custody seals YININA <br /> aeliri"uished Sin a Date/'Time received b si nature Dale 1 Time <br /> Sr 9 } Y ( g , ) Seals intact?YININA <br /> w?s� <br /> [Received good condition/cold <br /> Relinquished by (signature) Date!Time Received by (signature) Date 1 Time <br /> Turn around time <br /> Sample disposal Instructions Disposal @$2 00 each Return to client Pickup <br /> " L <br />