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Law iamaoWal ■w M M w = = = = " = = M <br /> 2852 All mne CA 92606 (94911 261 1022 FAX(949)261 1228 <br /> 1014 E Cooley Dr hon,CA 92324 (909)3704657 FAX(909)370-1046 <br /> t6525 Sherman Way SuRe C t Nuyc CA 92408 {Bt B)779 1844 FAx{B1 B)778 1843 <br /> 9464 Ch6cepeAe Dr Scale 805 San Dmpo CA 92123 46191 505 6596 FAX(6191 605 9689 <br /> 9830 south 5151 St Suke&120 Ptmnbr A2 85044 (486)785-0043 FAX(480)785-0851 <br /> CHAIN OF CUSTODY FORM Quote# Page of <br /> Clientt Name/Address Pro1ecVP0 Number <br /> 0I(AC$ L-ew TI ON marl bJ �Z-704 0- �: Anatysis Required <br /> 1`!33 ". lUtJ Ave 1-f �' <br /> Phr 2- �5-00-3 "mac is 1 c,N 4Q "` -, <br /> Project ManagerMIC Phone Number (�' ,i <br /> elt <br /> U _ <br /> 1 � N <br /> Sampler ! Fax Number <br /> dV1 fl-Ala., 07L} F i <br /> Sample Sample Container #of Sampling Preservatives I <br /> Description Matnx Type Cont Date[Time ) Special Instructions <br /> AAw3R— KE H70 <br /> VDA <br /> 1 <br /> AAW 36- Po�)-f 144 VC)p NSI <br /> L voA R-19-oz k t <br /> M t - � 1,3 <br /> 9,C D A►m f z <br /> t r, <br /> Rem fished y Dale r rime Received b Date!Time <br /> ( f 7 y Turnaround Time (Check) <br /> �~ 11- G 2-G Z 17-34 11 2 same day 72 hours <br /> R linquished By Date/Time Received by Date/Time 24 hours 5 days <br /> 48 hours normal <br /> Relinquished By Date ITiFne Received in Lab by Date/Time Sample Integrity (Check) <br /> ; <br /> intact ' ' on ice I <br /> Note By relinquishing'samples to Del Mar Analytical,client agrees to pay for the services requested on this chain of custody form and any additional analyses performed on this project Payment for services is <br /> due within 30 days from the date of invoice Sample(s)will be disposed of after 30 days COC-GB l <br />