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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 /> ptr �y4Pf G Date: 1-/� Page: Of >' <br /> Client: ® Project Name: �Jaa S N 1�raC J.Gq T/'^tc (14 <br /> Address (a�fi aa• C <br /> � <br /> Collector: E. F.gtef Client Project#: <br /> Phone: ��/�7a103 Fax: <br /> Batch M -r164-P16-5' EDF#: <br /> Project Manager: Ro Ca phc l I <br /> PCS Raj 4 f*'-J <br /> PCE� TCrrE� <br /> p N C <br /> o v;�yl ch �rble o <br /> O o y U U <br /> } w m16 <br /> + m m C <br /> O O O O <br /> O <br /> Sample Container ° <br /> N <br /> e Type Comments/Preservative I- <br /> Sample ID net Sample Time Typ EL <br /> 0 i <br /> —10 C)RO X 3 140 L- <br /> -r 1(Go <br /> I ' as (dbL <br /> 000 <br /> 3 10 ( X Nac� <br /> -1 a8 Vi <br /> -S 09 <br /> • 1 t15 W n <br /> —G I IG t2 <br /> -G w <br /> vi <br /> Relinquished by: (signature) ate/Time Rec Iv d :(13i lure) Date/�ime � Total#of containers <br /> Notes <br /> 1s I- 10", / s— Chain of Custody seal Y INA <br /> Date/Time Seals intac Y INA <br /> Relinquished :(signature) Date/Time Received by: si ature) �a <br /> p Received good condition/cold QO STD. <br /> TAT . <br /> 271 6r 93a' Date/Time - <br /> Relinquished by:(signature) Date/Time R ed by:(signature) <br /> Turn around time: —'—_-----_ E— <br /> - Sample disposal Instructions: Disposal @$2.00 each Return to client _ Pickup _ _ ^ <br /> COC 133090 <br />