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Dolar Anal\cal <br /> 2852 Allon Ave Wine CA 92608 19491 261 1022 FAX(949)261 1228 <br /> 1074 E Coney 6r Suee A Colton CA 92324 (909)3766667 FAX(909)370 11146 /�'„�9�/ ��. rr✓J �_ <br /> 7277 iiayv.horst S WO 8 12 Von Nuys CA 91606 (818)779 1894 FAX(1318)779 1843 <br /> 9676 Suulil 5151 S1 Suite B 120 Phoenix A2 851394 4480)785-0043 FAX(406)78543851 <br /> 9409 Ci�sipcake Or SU,16 805 San nmgo CA 92123 71358$505 96%FAX(858)595 9689 <br /> CHAIN OF CUSTODY FORM Page of a <br /> C t nt NamelAddress Project/PO Number <br /> Analysis Reg <br /> i�j�— RequiredProject Manager r,) 4Phone Number <br /> 6D 2-r 72-fj-<-)"7u'7 <br /> Samply- � �� Fax Number Q <br /> Sample Sample Container #of Sampling Sampling Preservatives 4- <br /> Description <br /> Description Matrix Type Cont Date Time 04 Special Instructions <br /> > �i <br /> rJGU - ��- rot 4f 3j <br /> �DiOFs 1� <br /> I <br /> Relinquished By Date Time Received by oate/T'ime Turnaround Time (Check) <br /> y�7 2-710 j� same day 72 hours <br /> Relinquished Byate/Time Received by DateRme 24 hours 5 days <br /> r <br /> 48 hours normal <br /> Relinquished By Date/Time Receiv 6 b DaterFimeSample Integrity (Check) <br /> �1 5- intact on ice L <br /> Note By relinquishing samples to Del Mar Analytical client agrees to pay for the services rfy6tody form and any additional analyses performed on t is project Payment for services is <br /> due within 30 days from the dale of invou a Sample(s)will be disposed of after 30 days <br />