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r � � � <br /> Sierra Laboratories,Inc CHAIN F CUSTODY RECORD <br /> - 1525 Endeavor Place 714-758-9988 Date Page C of <br /> S I E R R A Suite D FAX 714-758-9692 <br /> w�owwrow [s Anaheim,CA 92801 <br /> Client: Cltcnt Prod Name USA Analyses Requested <br /> Address 95677 Client Pro} No 500—? Ta) <br /> For Client Use, <br /> Turn around requested v� <br /> � <br /> Immediate Attention <br /> Client rel Nola,,]8(+ ^f dvoc) Rush 2448 hours <br /> Rush 72-96 hours <br /> Client Prol Mgr Mobile Lab <br /> Normal o D&vs <br /> Client Sample No Date Time Sample Matrix Preservatives Container No of <br /> Con <br /> Liquid Solid Yes No Type lainers Remarks <br /> m— GI Gst63 x X <br /> yy <br /> —t)u 2 X <br /> MJIP BL cs5 2- � <br /> Sa ler' Sign a Received by S i(N-9 v?q- Date Time 16 Total No of Containers <br /> 5 <br /> 'k 11-1,0 '9 7 3 L The delivery of samples and the signature on this <br /> chain of custody form constitutes authoraation <br /> ell ish y 4z D e Time Received by Date Time to perform the analysis specified above under <br /> Q Sierras Terms and Conditions unless otherwise <br /> T,, fo os agreed upon in writing between Sierra and Client. <br /> Relinquished D to irne Rec ived at Laboratory by Date Time Total No of <br /> Containers Recd <br /> Special Instructlons �F Canci,t/lon samples rteeC Salvmvee d11�e`"�eCkontaii <br /> `x,Wiled 3 <br /> tact} v # <br /> { ' Property Lab40:d,,1, hf <br /> #<< ,proate l?heselvati s'4' � Othe = a� <br />