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SunStar Laboratories, Inc. Chain of Custody Record <br /> 3002 Dow Ave., Ste. 212 <br /> Tustin, CA 92780 <br /> 714-505-4010 <br /> Client: R'Y'p-' J C'c+->?": 'XDate: of IZ016C> Page: Of i <br /> Address: 3iq? ,' �cdco;l j. .ih' Sita: �-{z l'i`t Project Name: <br /> 3 <br /> Phone t14)-,�,7! 'Ot-�S� Fax: IL-) X71 (v i Collector: Client Project#: <br /> Project Manager: . 9 3i-f- " Batch#: EDF#: <br /> CU <br /> 1 a� <br /> O N C <br /> XC @ O # C <br /> O u0 CD l ~ - O <br /> X W f0 O x O a Z, V <br /> h F— mb UJ o ) O O <br /> + M M222rz <br /> Sample Container o 0 0 0 10 Lo Lo 0 0 <br /> Sample ID Date Sam led Time Type Type N N N N 0 0 0 0 0 1 c�a <br /> ¢ p YP YP Co co Co oo Co Co Co co co � Comments/Preservative <br /> `4 - 1 2 ` t7 t110 <br /> ' 4V 1 <br /> Relinquish:d by:(si nature)^ Date Time Re, Ved by:(signature) Date/Time Total#of containers ;�g Notes <br /> �Ua � / 11 / >•` Chain of Custody seal Y INA <br /> Relinqui ed by. ignature) Date I Time Rec 've (signature) Date I Time Seals intact. Y/ INA Sm. � A�+ <br /> � d� 0; C) Received good c ditionJcol L, <br /> Relinquished by:(signature) Date I Time Rece ved•y: signature) I t Date/Time <br /> Turn around time: Li�T�ip�';�;i�', <br /> Sample disposal instructions' Disposal @ S2.00 each Return to client Pickup <br />