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i°~o ~., <br />CORE LABORATORIES, INC. <br />No. 48765 <br />CHAIN OF CUSTODY RECORD <br />~` ;~ CUS70MER INFORMAi1Qf1' ,k <br />, <br />i COMPANY: ~ _ PROJECT NAMEAVUMBER: ~~ ' I <br />Q <br />sENO HEPORr ro: BIWNG INFORMATION \C ~D ~~ <br />ADDRE55~ O D RIIL Tb ~ <br />S. ~ / S .2 ADDRESS: ~ \ L~A~B JOB NO. <br />PHON /~ / ~' ~ /~/ eXT. /,7 <br />O DD PHONE O ~~ <br />FA% <br />7/9 67~-3.363 FA%: PO NO.: . Q (.~+ <br />\\, ,~ <br />saAVLE NO. snNrLE OFSa1PTlor1 "e :~~ Ix~ s " ~ G~ Q C ~~ REMARKS / O_ NS <br />/ "796c /9B o ~/ 6 0 6 er~R P/~9~c ! / / ! M ~ I . <br /> ~or4 °F <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />SAMPLER 0 ~ SHIPMEM ME7HOD: AIRBILL N0: <br />REQUIRED TURNAROUND" ~ SAME DAV ~ I 21 HOURS ~ ~ 48 HWRS U R HOU75 ~ ~ 5 DulYS ^ 10 DAYS ^ ROUTINE OTHER <br />L RELIhOUISHED ~' DATE DATE r '~ DATE <br />SIGNATUR o//p ~~ $I(aNATURE: SIGNATURE: <br />i v <br />PRIIITE~N~f~ MPANY' N u / ~ <br />1. RECENED B : <br />RE TIME <br />DATE <br />~ ~/ PRRffED NAME100-~ANY' <br />BY. "' $f!''•:: <br />SIC~IATURE: TIME <br />DATE PRINTED NAMfJCOMPANY <br />I ! ', <br />SIGNATURE: TIME <br />DATE <br />RINTE NAMEICOMPANY. ME PRNTED NAMEIDOIffANY: 11ME PRINTED NAMEICOMPANY. TIME <br />RUSH TURNAROUND MAY REWIRE SURCH <br />AR <br />GE- <br />^ Ana6nm, GlNern~ ~ <br />/ <br />• I lU.r.r. loanrwl. c.1.rWo <br />1750 E. Gme Awir W+Y 10107 E. On NnY O~rv+ <br />AruNim. Gl~lo~nu 97605 Auror+, LOIn1+E080011 <br />111/1971 ~ 1091 17071 151 1160 <br />18001/0/ 1617 180019I7~7617 <br />^cw.aYY6 ^Caw+CYrwu,TOa <br />130 Me11o Aral 17D Nona fh8n Ia4n0 Orin <br />C,qe, WYOmhq t7®1 Grpa 6Nal.Tn++18M18 <br />170713768711 61717076'17 <br />10001666-0b6 160015N8776 <br />^ Xwnw, T+aa ^ GY, CWrb, Lweiwa <br />RIO Yaalry flob 7615 Og6+fhr6way <br />Heu,tOn. Tlua 17975 $ul08ur, LOn1+YM 19667 <br />R171917811fi 171915871976 <br />180011 ]/ ~7fii7 100017997976 <br />^ Len6 6+~6, Glilernu <br />7100 C6nry Aaenu, <br />Lola Borg Cahlarnn 90601 <br />11101 59 5 810 1 <br />Isom ewa.v <br />ORIGINAL <br />