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MarAnakocal <br /> I* <br /> Alton Ave Imne CA 92606 (949)261 1022 FAX(949)2611228 <br /> 1014 E Cooley Or Suite A Colton CA 92324 (909)370-4667 FAX(909)370.4045 <br /> 7277 Hayvenhurst Suite 9 12 Van Nuys CA 91406 (818)776 1844 FAX{818)779-5843 <br /> 9830 South 5151 SI Suite 8 120 Phoenix AZ 85044 (480)7850043 FAX(480)785-0851 <br /> 94114 Chesapeake or Suite 805 San Diego CA 92123 (858)5059598 FAX{858)505-9609 <br /> CHAIN OF CUSTODY FORM Page °Z of� <br /> Client Name/Addresp Protect/PO Number <br /> Anal 515 Required <br /> 6� �' Z <br /> Protect Manager Phone Number d Z 4 <br /> 1 ta C3 <br /> Sampler Fax Number 6M v ip <br /> XSic <br /> S <br />' Sample Sample Container #of Sampling Sampling Preservatives <br /> Description Matrix Type Cont Date Time *y ';^ Special Instructions <br /> X , Jams <br /> 1309X x x <br /> AVPIkif $r <br /> Rel uished By DateMme Received by DateRme Turnaround Time (Check) <br /> `rLZ-4 l same day 72 hours <br /> i <br /> Relinqut ed By DaWrime Received by DatefTime 24 hours 5 days <br /> 48 hours normal -� <br /> Relinquished By DateMmeRecely od in La b Daterla Sample integnty (Check) <br /> r , <br /> V2_ l 16 < < ) Intact on Ice <br /> Note By relrnquishing samples to Del Mar Analytical client agrees to pay for the services req sled on this chain of custody f&rtn anb any additional analyses performed on 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 />