DESTILERIA LIMTUACO & CO., INC. DESTILERIA LIMTUACO & CO., INC.

QA Department QA Department
QA Sample Collection Slip QA Sample Collection Slip

Sample/s Name: Sample/s Name:

Sample Code: Sample Code:
Analyze for: Analyze for:
Sampled By/ Date: Sampled By/ Date:

CP# 1-3 CP# 1-3

DI Water Sample DI Water Sample
Filling Chamber Filling Chamber
Big Hose Big Hose
CP# 4-9 CP# 4-9
Small Hose Small Hose
Nozzles Nozzles
Treated Caps Treated Caps
Rinsed Bottle Rinsed Bottle
Final Product Final Product
Puree Puree

DESTILERIA LIMTUACO & CO., INC. DESTILERIA LIMTUACO & CO., INC.
QA Department QA Department
QA Sample Collection Slip QA Sample Collection Slip

Sample/s Name: Sample/s Name:

Sample Code: Sample Code:
Analyze for: Analyze for:
Sampled By/ Date: Sampled By/ Date:

CP# 1-3 CP# 1-3

DI Water Sample DI Water Sample
Filling Chamber Filling Chamber
Big Hose Big Hose
CP# 4-9 CP# 4-9
Small Hose Small Hose
Nozzles Nozzles
Treated Caps Treated Caps
Rinsed Bottle Rinsed Bottle
Final Product Final Product
Puree Puree

DESTILERIA LIMTUACO & CO., INC. DESTILERIA LIMTUACO & CO., INC.
QA Department QA Department
QA Sample Collection Slip QA Sample Collection Slip

Sample/s Name: Sample/s Name:

Sample Code: Sample Code:
Analyze for: Analyze for:
Sampled By/ Date: Sampled By/ Date:

CP# 1-3 CP# 1-3

DI Water Sample DI Water Sample
Filling Chamber Filling Chamber
Big Hose Big Hose
CP# 4-9 CP# 4-9
Small Hose Small Hose
Nozzles Nozzles
Treated Caps Treated Caps
Rinsed Bottle Rinsed Bottle
Final Product Final Product
Puree Puree
DESTILERIA LIMTUACO & CO., INC. DESTILERIA LIMTUACO & CO., INC.
QA Department QA Department
QA Sample Collection Slip QA Sample Collection Slip

Sample/s Name: Sample/s Name:

Sample Code: Sample Code:

Analyze for: Analyze for:

Sampling Date: Sampling Date:

Sampling Time: Sampling Time:

Collected by: Collected by:

Received by: Received by:

DLCI-QA-44rev.00 DLCI-QA-44rev.00
DESTILERIA LIMTUACO & CO., INC. DESTILERIA LIMTUACO & CO., INC.
QA Department QA Department
QA Sample Collection Slip QA Sample Collection Slip

Sample/s Name: Sample/s Name:

Sample Code: Sample Code:

Analyze for: Analyze for:

Sampling Date: Sampling Date:

Sampling Time: Sampling Time:

Collected by: Collected by:

Received by: Received by:

DLCI-QA-44rev.00 DLCI-QA-44rev.00
DESTILERIA LIMTUACO & CO., INC. DESTILERIA LIMTUACO & CO., INC.
QA Department QA Department
QA Sample Collection Slip QA Sample Collection Slip

Sample/s Name: Sample/s Name:

Sample Code: Sample Code:

Analyze for: Analyze for:

Sampling Date: Sampling Date:

Sampling Time: Sampling Time:

Collected by: Collected by:

Received by: Received by:

DLCI-QA-44rev.00 DLCI-QA-44rev.00