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SunStar Laboratories, Inc Chain of Custody Record <br /> 326 Encinitas Blvd, Ste 150 <br /> Encinitas, CA 92024 <br /> 1-800-900-9333 <br /> Client ,T �4t Date { Page Of. Jr <br /> Address I 0_40 Protect Name " <br /> Phone 'Z WI " S7 i " "� Z Z Fax 216.4 - 's 7 9 • 2 z 3 Collector Vo ire S .. . Client Protect# <br /> Protect Manager 1#e go in A It vv, Batch# Proposal# <br /> N <br /> 4l <br /> Co _ <br /> 0N W f— C <br /> co CD C) <br /> O O 0 <br /> tl) 0 <br /> w N M N m rw- r r � O f0 0 <br /> CD <br /> Sample Container Q ¢ ¢ Q a a Q ¢ ¢ . <br /> Sample ID <br /> Date Sampled Time Type Type u�j w w W W w LU LU w w ii Comments ° <br /> �" Q 'ii # w�k4.K.stI I I <br /> 1� <br /> k <br /> t <br /> ,t Ir <br /> j <br /> c <br /> Relinquished by (signature) Date 1 Time Received by (signature) Date 1 Time Total#of containers `-', Notes <br /> Lt� ,�^7 rt 4 ,.k If Chain of Custody seats Y/N/NA ria 'gF sv F a _ f. s „ rbc <br /> Relinquished b (signature) Date 1 Time Received b > (signature) Dale I Time <br /> q Y � g Y ) Seals intact?YININA <br /> Received good conditionlcold 1 l i,~, <<r'r', `^' e, <br /> Relinquished by (signature) Date 1 Time Received by (signature) Date I Time <br /> Turn around time��i��(T�r <br /> 5arnple disposal Instructions Disposal @$2 00 each � Return to client Pickup ` <br />