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Mir- "IIvM-M 14MU M = = W = = = M <br /> ey D Irviow CA 92608 (949)261 1022 FAX(949)tet 1229 • <br /> 1014E Way S D Qorion,CA 92324 (Bos)370-4687 FAx(90)370 1046 <br /> 16525 Sherman Way Soil !en Nuys CA 92408 (516)779.1844 FAx(91 9)T79 1343 I/,, +/'176�8494 Che:"W.or SWIG 805 Sen Diego CA 92123 (519)505.9596 FAX(819)505.9689 Mo�(J I`ie 604-.� <br /> 9830 S013h 51st SI Sud-B 120 Pts n6r AZ a5044 (480)7&50043 FAX(480)785A&Sl <br /> 7 <br /> CHAIN OF <br /> Client Name/Address CUSTODY FOR e# <br /> I � Pralect/P0 Number Page � of t <br /> BI0'P-!5 i���vYt� Mz--70950^©� Analysis Required —+— <br /> z:3 <br /> Project Manager Phone Number <br /> 13re# A44, �tl (z6Z-7Z8-- ®7o7 �° $ <br /> TT <br /> Sampler f,r iI Fax Number J a <br /> k Qt t�2-7Z,7-070g <br /> Sample Sample Containei of Sampling Preservatives X <br /> Description Matrix Type Cont Datef ime (� a <br /> i <br /> #� E — ) Air— Special Instructions <br /> TEMA <br /> VFW - 2 914. Z �'�� <br /> Lt r< tI <br /> I <br /> i <br /> ReL mshe Date!Time <br /> rRe!i <br /> d byii <br /> �7 a�/Time �� Turnaround Time (Check) <br /> a Ra mqulshed By Date Mme ed by [� same day 72 hours <br /> Date Mme <br /> Relingwshed By Date 24 hours 5 days <br /> Mme Received in Lab by 48 hours normal I" <br /> Date/Time Sample Integrity (Check <br /> intact on ice <br /> 1e By relinquishing samples to Del Mar Analytical,client agrees to pay for the 5@MC85 requested on this Chain of custody form and any additional analyses performed on this protect Payment for servrces is <br /> within 30 days from the date of invoice Samples)w111 be disposed of after 30 days <br /> COC-GB <br />