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�. C '�MarAnalydcal <br /> 2852 Alton Ave.,!nine•CA 92606 (948)261-1022 FAX(949)261-1226 <br /> 1014 E.Cooley Or,.Suite A.Cdton,CA 92324 (909)370.4667 FAX(9091 370.1048 <br /> 9484 Chesapeake Dr.,Suite 80.5,Sari Diego,CA 92123(858)505,8596 FAX(858)505-9689 <br /> 9830 South 51st St,Some B-120,Phoenix,AZ 85444 (480)765-0043 FAX(4W)785.0851 CHAIN O F CUSTODY FORM Page of _J_2520£.Sunset Rd.93,Las Vegas,NV 89120 (702)79&3620 FAX(702)798.3621 <br /> Client NametAddress: ) ProjectIPO Number: Analysis Required <br /> �C <br /> T A .` <br /> 73 <br /> Project Manager: I Phone Number: <br /> Sampler: Fax Number: <br /> Sample Sample Container #of Sampling Preservativesp �7 tj <br /> Description Matrix Type Cont. DaterTime tW Special Instructions <br /> 6)r) �F `' g r�'# I ,vX- x <br /> LO <br /> t.t <br /> I <br /> I <br /> I <br /> I <br /> i <br /> I <br /> I <br /> i <br /> i <br /> I <br /> I <br /> I ti <br /> i Date lFime: Received by: <br /> Date!Time: Turnaround Time: (Check) <br /> Relinquished By: / <br /> 1 ' v, <br /> 17 same day 72 hours <br /> Relinquished By: Date crime: Received by: Date(Time: 24 hours 5 days <br /> 4 <br /> 48 hours normal <br /> Relinquished 8y: Date lime: R ed b Daa I.a(Time, ]�(C�--7711 Sample Inte city: (Check) a <br /> e ?i"1 LJJ intact on ice ✓ <br /> Note: By relinquishing samples to Del Mar Analytical,client agrees to pay or the servicen this chain o custody form and any additional analyses performed on this project. Payment far services is <br /> due within 30 days from the date of invoice.Sample(s)will be disposed of after 30 days, COC-GB <br /> i <br /> I I <br /> I � <br />