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bi~:_' <br />CORE LABORATORIES, INC. <br />N0.'+L4JU <br />CHAIN OF CUSTODY RECORD <br /> <br />'..; ; <br />~` ~ .~~~ ~ ~ ~ ]n <br />..~ - - <br />~ ~ ~ <br />Q e- '` ~ c <br />`~ A <br />~ <br /> <br />COMPANY' <br />Dp <br />~~~~ ~ N LuSS <br />PflOJECT NAMEINUMBER~ <br /> <br />` .~ <br /> <br />\ <br />SEND REPORi <br />SALLY 'I Y~ 5 BILLING INFOR MATION ¢ u' ~ ~ ~.~ <br />ADDRESS: d ~ 0 BILL TO: ,Y <br />H ~' <br />Ski LU15 0 I Z ADDRESS = •r ~ a <br />~ LAB JOB NO. <br /> ~ <br />"~ //~~' <br />~ <br />b 93~ ~"Zo <br />PHIXJE. <br />4 6 7~2 - 3 3 S PHONE _' ~ <br />~W Q/ <br />,o'~ V~ 5 <,'~ ~~ <br />FAX FA% PO NO' • <br />Q .O \ <br />~:~ - ~`r. ~SAMPE RE I I <br />~'' ~ <br />~ a ~ ~~. <br />=» ~ • <br />: ~NPL.E '. <br />-, AT ' <br />` SAMPL,E:': <br />"• .,-.$AATLE <br />TBI>R <br />jb,N'fAll/IER~'PE, <br />?AEBEQv ~.. Q( Q ~ ' / <br />O Q REMARKS /PRECAUTIONS <br />I 5 9 p U 0 9 09 -~Pl P he • E GSS 1 2 1 1 1 I I <br />~~ 9 s o 0 o9vo <br />3 X151 o O 1311 G O W zo ~-.~o '. ~ `~ ;t. <br />y 951069 13H o5 S ° m G I~ t ,V' • <br />5 4 1 0 9 6 I'I G d6 q eri' ~~ S / . V <br /> <br /> <br /> <br /> <br /> <br />SAMPLER' U ~ (,~ SHIPMENT METHOD AIRBILL NO.: <br /> <br />REQUIRED TURNAROUND' I I SAME DAY ^ 21 HOURS <br />I D: : ` m r '< ~ •.P ~: ' _ "' <br />SIGNATURE: / ~ 5 " <br />^ 48 MUURS <br />D~YT~L <br />/ V/({ Q I^~ ,y~~ ,1 <br />~ 72 HOUR$ ^ SDAYS ^ 10 DAYS ~ ROUTINE OTHER Fax r(~IIa V//G~LI <br />ELiN ><. ] y t` DATE <br />NAT E ro q IAl SIGNATURE <br />eSL/~~ G <br /> <br />DATE <br />PROfT~6 NAME/COMPANY' ~ _ u <br />I. REC ED BY. '= x5 ` ' '~ ~ <br />SIGNATURE: V TI~ ~ <br />DATE ,,,/// <br />~//O~Lq <br />I/ IN AM C AN~ - <br />. RECE <br />SIGNATURE ~ C <br />J:3 <br />_ SIMEwv1 <br />DATE PRINTED NAMFJCOMPANY: <br /> <br />SIGNATURE TIME <br />DATE <br />PRINTE C PANY: A e~ TI M PRINTED NAMEiLOMPANY TIME PRINTED NAMFJCOMPANY 71ME <br />RUSH TURNAROUND MAY REQUIRE SURCHARGE <br />^ Aruhnm, Ghtprua I~AUmn IOunrl, Colpn9q ^ LaaPer. WYOminO <br />1750 E Gene Awry W r 10107 E. BnMnr Orne <70 Wen In Slmn <br />Anahmm, Glilornia 97805 a Aurou. Lp I011tlp 8001< Gmer. Wypmmp 97601 <br />Il pl B]7 ~109a - 170711911190 1301177551AI <br />1!001 AOa 7677 18001917 761] I8001666~0706 <br />^ Cprpua Lhrirt~, iom ^ Hounpn, Tun ^ 4La Chnln. lounima <br />1171 Nonh Padre bgntl Onve 8710 Money Rpotl 3645 Beg6a Poawar <br />[prpm C6nni. Tears IBCOB Hpunon,TUn 11015 9Ylpnw, LOY6Nnd 10667 <br />151717697613 p1719A7~91 ]6 1]I BI S9N976 <br />IB0015AB8779 1800117A36/3 180017594976 <br />ORIGINAL <br />^ Lonp Buch C.Llomn <br />7100 LFluy Avenue <br />Lonq Beun. G61pm~a 90601 <br />13101 595~Aa01 <br />IB001 B 11 7.77 <br />