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CD arAnalytical <br /> n <br /> A. frvrno CA 921,06(999)261 7022 FAX(04 9)261 t228 �4 <br /> 1014E Coafoy S M.A Callon CA 92724(909)37x4667 FAX(909)3707016 <br /> 7277 F43yve hursl1-1 5, Sure p 72 Von Nuys CA 97 145(916)785 0043 FAx 19191779 1647 <br /> 9830 Saulh 51st 51 Supe B 170 F'IwcnQ AZ 85044(480)765 0043 FAx(4901 785 p&51 ,,4411- r'�—+ '`++V`.`�C•,+r'!!' l <br /> 9494 Cii-apaaku Or Sudo 605 San Diego CA 92123 485a)Soy 9596 FAX(9581 505 9689 <br /> CHAIN OF CUSTO FORM Page of <br /> Client Name/Address Prolect/PO Number <br /> 701-SZ) <br /> Project <br /> Required <br /> Project Manager Phone Number 4 c �. <br /> Sampler �� Fax Number I� 1 <br /> ✓ate 6 0 <br /> Sample Sample Container #of Sampling Sampling Preservatives v�1 <br /> Description Matrix Type Cont Date Time <br /> Special Instructions <br /> M _r—/2,01 <br /> 1 <br /> w to - f zo ! <br /> ) <br /> Rekn cashed Bye Da e lime Received by Date Mme <br /> JFI � Turnaround Time (Check) <br /> same day 72 hours <br /> Relinquished By Date Mme Received by Date Mme <br /> 24 hours 5 days <br /> Relinquished By shed By Rate!Time Recew in Lab by r Date Mme 48 hours normal 1V <br /> r f,� Sample I fegn (Check) r <br /> v � <br /> 2 t intact on ice <br /> Note By relinquishing samples to Del Mar Analytical client agrees to pay for the services request on this chain o(cuSt y form nd any additional analyses performed on this protect Payment for services is <br /> due within 30 days from the date of invoice Sample(s)vAll be disposed of after 30 days <br />