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as <br /> 1G�IeySDTMJ�ir>*A Cai2324 V t w 09)3 <br /> t¢G� 7277 Hayvenhursl Suite B 12 Van Nuys CA 51406 (818) FAX(81 BJ 779 1843 <br /> l Mar Analytical 9484 Chesapeake or Suit 805 San Diego CA 92123 (850) 6 FAX(480)585 8569 <br /> 101 �+� 9830 South 51st SI Suits 8 120 Phoenix AZ 85044 (480}78 043 FAX(480)705.0851 <br /> 2520 E Sunset Ad Suite 3 Las Vegas NV 69120 (702)798 3620 FAX(702)798-3621 <br /> CHAIN OF CUSTODY FORM Page of <br /> C ien I amefAddress ProjectlPO Num er r, <br /> /y)Q TC r - Analysis Required <br /> n� /� L�- I � -709 <br /> �n 3 <br /> �31 o o <br /> Project Manager Phone Number <br /> 6 6Z -7 2_7 8 1 V� \A o�kr <br /> 4 <br /> Sampler Fax Co uNumber Z p. <br /> Sample Sample Container #of Sampling Sampling Preservatives C-_ <br /> Description Matrix Type Cont Dale Time �LX� 1st Special Instructions <br /> r <br /> 6(667L A <br /> IA1 _ <br /> l U.3 - C_-tiro o <br /> rq L&J 6o7- <br /> W--S 3--oGa _L 1-539 X Y� <br /> Mw -,ge--o Goy- 1515 7< � <br /> M6v -t56r�z <br /> Re shy By r Date/Mme Received <br /> Received by Date!Time Tumaround Time (Check)b-ZC -C)Z-�v 2,0 same day 72 hours <br /> elmquished By Date Mme Received by ' Date Mme 24 hours 5 days <br /> 48 hours normal <br /> Relinquished By Date Mme Receiab ZDate Mme <br /> Sample Integrity (Check) <br /> 6-7-1-02— 3b intact on ice c L� <br /> Note By relinquishing samples to Del Mar Analytical,client agrees to pay for the services requested on this chain of c stody form and any additional analyses performed n this project Payment for services is <br /> due within 30 days from the date of invoice Sample(s)will be disposed of after 30 days <br /> I <br />