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SunStar Laboratories, Inc. Chain of Custody Record <br /> 25712 Commercentre Dr <br /> Lake Forest, CA 92630 <br /> 949-297-5020 <br /> Client: Date: Page: Of <br /> Address: Project Name: <br /> Phone: Fax: Collector: Client Project#: <br /> Project Manager: Batch#: EDF#: <br /> T � N <br /> C V N <br /> O <br /> } 0 N C <br /> XO C 2 N *k (0 <br /> X X X m u) U o O <br /> O w o `O 12 <br /> o <br /> + m m m xt <br /> Sample Container C) C) CD C) �, � � � 0 m <br /> Sample ID Date Samplec Time Type Type 00 Co 00 00 Co Co Co Co Q0 Comments/Preservative <br /> Relinquished by: (signature) Date/Time Received by: (signature) Date/Time Total#of containers Notes <br /> Chain of Custody seals Y/N/NA <br /> Relinquished by: (signature) Date/Time Received by: (signature) Date/Time Seals intact?Y/N/NA <br /> Received good condition/cold <br /> Relinquished by: (signature) Date/Time Received by: (signature) Date/Time <br /> Turn around time: <br /> Sample disposal Instructions: Disposal @$2.00 each Return to client Pickup <br />