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SunStar <br /> Laboratories, Inc. Chain of Custody Record <br /> PROVIDING QUALITY ANALYTICAL SERVICES NATIONWIDE <br /> 25712 Commercentre Drive, Lake Forest, CA 92630 <br /> 949-297-5020 <br /> Client:I�V� Date: toIWZ02—i Page: Of�_ <br /> Address:gi' i WPL457 AI, i, L Mi, i! !a �V Project Name: M eUi rrA1 t.J 3" ' <br /> Phone:ZM ;WLA. -54?2-;�- Fax: Collector: Client Project#: (\.l-/--Vq <br /> Project Manager: M I i•ACiCi4- Batch#: T Z.I 1 EDF#: <br /> c � <br /> U <br /> O N [6 a)O N a)k X c N ! <br /> "' <br /> 0 <br /> O H w oo o <br /> EQ + CO m �� <br /> n Date Sample Container o 0 0 o C- P o o _ <br /> Sample ID Sampled Time Type Type N N N N o 0 0 0 0 o a Comments/Preservative ° <br /> P P YP YP eo m o w m co eo ao co cc �J I- <br /> 28 <br /> �!d �f ADS ai1- 111 W. - - - <br /> -Z 1_. az <br /> 5 <br /> c-2 -X2- O IL. 1 14OZ- <br /> IS$94- -S&)Ls <br /> Z I 10q 5 so tL- <br /> .3.2021 1106 C I L- <br /> 91d� �st <br /> ,5S1-4 .Zc�- (0.3•�1 IZ2.0 JL- I I 1 40vEwt <br /> ti14 <br /> r q 2�2 12201L <br /> to-3 ' t Sv► 9 - <br /> Reli is b : (signature) >Date/Time Receiv by: (signature) n `Date/Time Total#of containers Notes <br /> doZP e2-> Chain of Custody seal Y N/NA (j T) T <br /> Re quished by: (signature) Date/Time Rec iv d by: (signature Date/Time Seals intactN/NA <br /> p e <br /> 0 S72- Received good condition/cold 7 <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 />