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t115t trnt '10vc of cv <br /> v 10 odey Dr use Colton 2324 3 909)370 1046 <br /> 7277 Hayvenhursl Suite B 12 Van Nuys CA 91406 (818) FAX(81 8)779 1843 <br /> 9484 Chesapeake or Suite 805 San Die CA 92123 a58 5 FAX 858)505-9569 <br /> tF ! Mar Analytical 9830 South 51 at St Suite B 120 Phoenot AZ 35044 (490)765 0043 FAX(480)7M-Mll <br /> 2520 E Sunset Rd Susie 3 Las Vegas NY 39120 (7o2)798 3620 FAX(702)798-3621 <br /> CHAIN OF CUSTODY FORM Page z- of -2— <br /> Client Name/Address Project1P0 Number <br /> Analysis Required <br /> _ C, ) <br /> 1 S <br /> Lt. <br /> Project Manager Number <br /> -4- <br /> Sampler <br /> Sampler Fax Number <br /> Sample Sample Container #of Sampling Sampling Preservatives O <br /> Description Matrix Type Cont Dale Time 00 ILSpecial Instructions <br /> 03 <br /> MW <br /> Rein uish By Dale Mme Received by Date Mme Turnaround Time (Check) <br /> ~ <br /> C-? �o Z-0 same day 72 hours <br /> Rei nqutshed By Date/Time Received by i Date Mme 24 hours 5 days <br /> 48 hours normal <br /> Relinquished By Date Mme Received n b by Date/Time Sample Integnty (Check) o <br /> z1.NZ 0430 Intact on ice C.. <br /> Note By relinquishing samples to Del Mar Analytical,client agrees to pay for the services retfuested 15n thi&1chain of ustody form and any additional analyses performed on this project Payment for services is <br /> due within 30 days from the date of invoice Sample(s)wall be disposed of after 30 days <br />