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-���_ l- � � � 101�1ey Dr Colt324 U-4fi609)37� <br /> 7277 Hayvenhurst Suite 8 12 Van Nuys CA 91408 (818)77w" ' <br /> AX(818]7751843 <br /> LSI Mar Analytical 9484 Chesapeake or Suit 805 San Diegoix CA 42129 (858)50AX(SSB)505-8559 <br /> 9836 South 51st Si Suite B 120 Phoenix AZ 85044 (480)78AX(480)7850851 <br /> 2520 E Sunset Rd Suite 3 Las Vegas NV 89120 (702]79AX(702)798-821 <br /> CHAIN OF CUSTODY FORM Page of <br /> Client Name/Address ProjectIPO Number <br /> g lf7 7L)}t!1 YC7Y1 � CZ(�Z, '�t� s� �' Analysis Required <br /> 11 Vt"T <br /> Project Manager Phone Number Q, <br /> Sampler Fax Number L "b <br /> �Tt-"M God, Z 8 a1 Q -- p <br /> CAM <br /> Sample Sample Container *of Sampling Sampling Preservatives NJ Z <br /> Description Matrix Type Cont Date Time Special Instructions <br /> V05— —G VoA Z Q-zw o�3o 40 00V Ana 1,z z, <br /> r - 5 <- ,on�,3,�s �< i T�>^e- � s <br /> a pl-A lzwv W'/' <br /> U�- L Oslo T4 9- zq-oz <br /> C. c6W <br /> Retln u he By i Da Mme Received by Date Mme Tumaround Time (Check) <br /> —6Z 0 same day 72 hours <br /> Rellnqulshed By Date/Time Received by Date[rime 24 hours 5 days <br /> 48 hours normal <br /> Relinquished By Date Mme Received in La <br /> Date lTlme Sample Integrity (Check) u <br /> intact �I on Ice r s� <br /> Note By relinquishing samples to Del Mar Analytical,client agrees to pay for the services requested on Is custody rm And any additional analyses performed on this project Payment for services is <br /> due within 30 days from the date of invoice Samples)will be disposed of after 30 days <br />