Laserfiche WebLink
Cie <br /> C DelIVIarAnalytical <br /> 852 aitan A e Irv,ne U 92114 111 al 161 1077 FAh 17141 261 1278 57403 <br /> 1014E Coley 0, S-eA Colton CA 92374 19091370 466Y FAX 190913701046 <br /> 16525 SW—n Way Surte C I S Van Nuys CA 91406 IBI81 719 1844 FAx 18 101779 1843 <br /> 2465 W t 2th St Sate I longe AT 85701 16071 468 6272 FAX(6021 9168 1358 <br /> CHAIN OF CUSTODY FORM <br /> Client Name/Address Pfoject/PO Number Analysis Required <br /> U HAL(L k 7oq—`3-) soT� <br /> �27t-) N wiLY-41d LJP- `Y Qk 4 <br /> Project Manager/Phone Number Sampler <br /> P9, D o E k�rel �H 'T K'l c'� z �u <br /> Sample Sample Container #of Sampling Preservatives Q. <br /> Description Matrix Type Cont Date/Time Special Instructions <br /> Refinqu4ed B Date Tme Received by Date(Time Turnaround Time (check) <br /> same day 72 hours <br /> Relinquished By Date J Time Received by Date!Time 24 hours 5 days <br /> 48 hours normal <br /> Relinquished By Date(Time IRMLabby ^ Date ITtime Sample Inte rity (Check) <br /> ntact on Ice _ <br /> Note Sample(s)will be disposed of after 30 days <br />