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SunStar Laboratories, Inc. Chain of Custody Record <br /> 25712 Commercentre Dr <br /> Lake Forest, CA 92630 <br /> 949-297-502`0 p <br /> Client:�GiJ t�2✓ �1�1�t�N2�✓lN�� p �j--61ce/nc - Date: /gyp ttV V4 VD1LI Page: Of 7- <br /> Address: <br /> Address: Project Name:-L407, S(A I. OyIniA - rte, ��Gkt�Ylt(Q 9SZa6 <br /> Phone: 1� Fax: Collector: le-7m Client Project#: <br /> Project Manager. SLtn1Gd^-kklet Gly✓tS' - - 'Batch EDF#: - <br /> Q <br /> i N O <br /> S <br /> E U to m <br /> V! O N C <br /> v x' d m <br /> o X m Z o <br /> w m a <br /> Sample Container <br /> Sample ID Date qamplet Time Type- Type �7 `� Comments/Preservative 91 <br /> l-S MOM 8�4$A -I QC%Y I I I Ivi <br /> BZa z QI X I I X 1 161 <br /> 3--5 `t`zZZZbf.n � <br /> 9'im -L on+ a <br /> i 5C11 014" ° <br /> _sergo a, or' <br /> • -fi9 Ifzs a.» ok <br /> _j r 0=000» 10 <br /> I X It <br /> O'N is <br /> R (sl nature) /p D e/Time Receiv by:( ' Date/Time y� / 7.4 Total#of containers Notes I� W ✓� —��y/ Ehain of Custody sea /NA <br /> Rehnq d by/:'(signature) Date/Time Recei tl b Date/Ti Seals! c� /UNA <br /> GSO L('ZS�U{ �ZS 4 <br /> Received good oondifion/cold5.7- <br /> Relinquished by:(signature) - Date/Time Received by:(signature) at /Time �( <br /> Turn around time: 1 - "--'- <br /> Sample disposal Instructions , Disposal @$2.00 each Return to client_ Pickup <br /> -- COO 35500 _ <br />