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SunStar Laboratories, Inc. Chain of Custody Record <br /> 25712 Commercentre Dr <br /> Lake Forest, CA 92630 <br /> 949-297-50y200 `` <br /> Client: / 'sT- Date: ►c/y71tr Page: L Of i <br /> Address: 41-703 T-/jpoa tes`lt-tZ )9-Vje. ,S F,43 6,'Oh /9ti0eCA Project Name: 8"I—ml 'ib(U-17`M/i� pl'C.L <br /> Phone: Sf a 3 —cJZo 0 Fax: ��G=y— 674 9 y6 0 t Collector. 5TVhW 1 125 Client Project#: <br /> rolecManager:_ Batch#: T ///59.3 EDF#: <br /> . U m <br /> s <br /> C N <br /> O O N <br /> Y m a N <br /> N N U ~ O <br /> O F F m : W Q Q U <br /> O O <br /> Sample Container ^ m 0 o <br /> Sample ID Date Sample( Time Type Type m m m m m W Co m Comments/Preservative F <br /> —2 — Vou L t <br /> o 77 r l'00 5011- <br /> A <br /> 0 1- 05 1 <br /> /- /it a c o St t <br /> o ?,ill) <br /> S —3- o [ 6 l <br /> Relin hed by: gnature) Date/Time Received by:(signature) Date/Time Total#of containers Notes <br /> r%ifr► 17-00 lost) t(�ki�+ub# 10'12 W a <br /> Chain of Custody seal/NA <br /> elinquished by: (signature) Date/Time Received by:(si n tur Date/Time Seals intact. Y /NA <br /> 61 �S .-k Received good condition/cold 0 <br /> .� p_� t[ 0 <br /> Relinquished by: (signature) Date Time Re ' d by: (signature) Date/Time ��t <br /> Turn around time: St fJ <br /> Sample disposal Instructions: Disposal @$2.00 each Return to client _ pickup <br /> COC 101118 <br />