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010 Aw kvm CA 92808 (949)2a1 1a22 FAX(949)2611228 l � `^ <br /> 71G1W4Dr Suva A Callon CA 92324 (909`37OA667 FAX(ON)3701048 <br /> *1- <br /> 16525 Sirerrrar Way suee C 11 van Nuys CA 92406 (SIS)778-1 944 FAX(818)779-1843 y? GJ A—, I'-2 L CK-3 E L O A C <TO J <br /> 9434 Chunpeue Dr-Sole 906 San 05 9689 <br /> Dko CA92123 (610)505.95ae FAX(619)5 `r <br /> MMSc halmlSK'S 00120 Ph"nix AZ 05044 (4)785-OMFAX(4W)765-Ml CHAIN OF CUSTODY FORM Quote No Page of ��.. <br /> Client Name <br /> — P 0 IProject Number 5E Z 6702� <br /> Address 6 1v S,,-4'4 20 -3 Project Name <br /> City ,j it ' State Zip Project Manager <br /> Tel -j CG7� Fax Samplers signature) <br /> ❑"s+' ❑ r El <br /> o0 ❑o m <br /> a c <br /> C <br /> CDm <br /> Zo ¢ ❑ a <br /> Elo W f <br /> O eW+ El 1`— [:] Q N N ❑ ` . <br /> C U C m Q ❑00 rte. ❑ � `�. <br /> E N LL)o nr- <br /> . O O N M <br /> X 00 <br /> Q Q1 N E of Ln tLy 1P) 7 a Q Q Q y Q 2 16 <br /> Sample I D g p a` Z c Co Co y u o CC (a w w +� w + a <br /> -/ U7,() I+j� Q! ��- O VJA y <br /> /4 w Z- Iv <br /> fEv- <br /> ,�it�-7 ►E t� <br /> Vii t3,� <br /> MIJ-8 <br /> a Rehnq fished by " ""— ` ate/T(me ateJ7ime Turnaround Time (check one) <br /> � Received by 3 Same Day 72 hours <br /> zog ell q fished bb DateTrime eceived by Dale (me 24 Hours 5 Days <br /> 1 1111111111, ��r(}9"C'1 f"" l _� C. 48 Hours Standard <br /> Re inqulshed by Dateffime y ye intab y ' } Datelrime <br /> v lr� <br /> it la �� 1 Sample Integnty <br /> Remalks Intact On Ice <br /> 1 <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 o! <br /> this project Payment for services 1s due within 30 days from the date of the invoice Sample(s)will be disposed of after 30 days rnv.r. <br />