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DE&arAnakocai <br /> 2652 Allan Ave IrvhM CA 92606 1949)261 1022 PAA 19491 261 1228 <br /> 7014 E Cooley Dr Sulu A Calton CA 92324 (909)3T04667 FAX(909)370 1046 <br /> 7277 t1.ly9C111w1s1 Sude 0 12 Van Nuys CA 91406 1518)779 1844 FAX(518)779 184 <br /> 911 $..d,51.1 St sue.0 120 Phuem.AZ 85044 (480)765 0043 FAX(480)765-0651 <br /> !8154 ChOsape1he De Sude 005 Stn Olego CA 92123(858)505 9596 FAX 1858)505 9689 <br /> CHAIN OF CUSTODY FORM Page of �- <br /> Client NamelAddressProjectlPO Number <br /> Anal sis Required <br /> 5e,e <br /> Project Manager Phone Numb <br /> Q �l U � <br /> Sampler Fax Number t6 4 <br /> i � <br /> Sample Sample Container #of Sampling Sampling Preservatives L <br /> Description Matrix Type Cont Date Time a4 d Special Instructions <br /> 4-Av- " .�I� <br /> 'OfPrr s--_Del a <br /> Arit,- C _vrytf VON <br /> Ude �`DQ <br /> Refinqed ay a6lime Received by DatelTime Turnaround Time (Check)�b � fi-=-::z L7 1 <br /> t 2'� r same day 72 hours <br /> Relinquished By Date/Time Received by DatelTtme 24 hours 5 days <br /> 48 hours normal X _ <br /> Relinquished By Datel-ime ReZP <br /> b/by DaterTme Sample lntegnty (Check) <br /> - I -zq-01 S� intact on ice_& nC— <br /> Note By relinquishing samples to Del Mar Analytical client agrees to pay for the services reqy farm and any additional analyses performed on this project Payment for services Is <br /> due wllhin 30 days from the dale of invoi(e Sample(s)wl3l be disposed of after 30 days <br />