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1moetey A C�92324=370 4M(909) <br /> J727714ayvenhurst Suite B 12 Van Nuys CA 91406 (818)779 844 FAX(818)779-1843 <br /> ,t J 1 9484 Chesapeake or Suite 805 San Diego CA 92123 (85B)5 FAX(858)505-9589 <br /> WI Marr Analy ical 9830 South 51st St Suite B 120 Phoenix A2 85044 (480) FAX(480)7850851 <br /> 2520 E Sunset Rd Suite 3 Las Vegas NV 89120 (7021 7 D FAX(702)798 3621 <br /> - CHAIN OF CUSTODY FORM Page J— of <br /> Client Name/Address ProjectlP0 Number <br /> V n„l rV,M4-Kr" 062- - sj�gs c �. Analysis Required <br /> YX Awt, <br /> Inn <br /> Project Manager Phone Number � <br /> 13rRll lA G67— -17-8 0101 N 41 Qi�aT� <br /> Sample rp n S� Fax Number Q 11 CD 4 ~ <br /> 1V1 (07 ��g cs-I o 8 = ul -A . <br /> Sample Sample Container #of Sampling Sampling Preservatives <br /> Description Matrix Type Cont Date lime �~ nD W Special Instructions <br /> AAW <br /> _ [, 4 `�ArAfit►^ �'-2y'at �� N N� <br /> w - S C C. 1-t,"', <br /> ISoo 1 41 <br /> Myj 11!315 <br /> uV 10C 1530 <br /> MW - L y �•Z o8-�D <br /> Ad LLJ NZ5 / X K <br /> —MW - T74f- 1300 <br /> Relinq she 8y D7!Time Received by Date Mme Turnaround Time (Check) <br /> c -6 Z / same day 72 hours <br /> Relinquished By Date Mme Received by Dale Mime 24 hours 5 days <br /> 48 hours normal <br /> Relinquished By Date Mme Received ab Date lime Sample Integrity (Check) <br /> s <br /> intact ✓ on ice <br /> Note By relinquishing samples to Det Mar Analytical,client agrees to pay for the services request on t of custody fo and any additional analyses performed on this project Payment for services is <br /> due within 30 days from the date of invotce Sample(s)will be disposed of after 30 days <br />