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IM1111111111 >• M AMJar�=nveganWRICA MW• (I776�- FAW08)OW30M <br /> UOIA ANALYTICAL 11819 Striker Ave , 8• Sacramento, CA 95834- (916) 921-9600 FAX (916) 921-01. <br /> ❑404 N Wiget Lan alnut Creek, CA 94598• (925) 988-9600 FAX (925) 988-9673 <br /> �, CHAIN OF CUSTODY ❑ 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954• (707) 792-1865 FAX (707) 792-0342 <br /> a z _ ❑ 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Company Name _44 Project NameMailing-Address 1 �c _ _ Billing Address (if different) { <br /> city V%t�ck _, ��, State Zip Code <br /> - Telephone ' V <br /> FAX# ' <br /> Zf`l ,57� ZZ2 t , PO # a <br /> Report ToSam ler <br /> I�r c•�+ �. l(� ,� p f Lw ,�, QC Data kevel D (Standard) ❑ Level C Ll Level B El Level A v <br /> x <br /> 7Urnaround 10 Working Days ❑3 Working Days ❑2-8 Hours ❑Drinking Water Analyses Requested <br /> (L <br /> Time ­ ❑ 7 Working Days ❑2 Working Days ❑Waste Water v` <br /> ❑ 5 Working Days ❑24 Hours [Other A� <br /> Client Date/Time Matrix # of Cont Sequoia's `�•�, <br /> Sample I D Sampled Desc Cont Type Sample # �C� Comments <br /> [. Sjjj <,%1 29( •-A.. <br /> 1"RAS - tw4-z, S ' 1 16S.es <br /> 0 <br /> 2 )( )( <br /> 4it <br /> 5 11A z_/J <br /> 6 <br /> 7I_L�, � 1 '� Or <br /> I Li � �_7Li L - ° <br /> x U) <br /> 9 <br /> 10 <br /> Relinquished By __ Date071617 Time M45' Received By Date 7 Time <br /> Rehnquished By Date Time Received By Date Time ` <br /> B _ <br /> Relinquished Date Time <br /> q Y � Received By Lab Date Time <br /> -Were Samples Received in Good Condition9 Q Yes ❑ No Samples on Ice? U es 0 No Method of Shipment &UVJ 4.t., Page f of <br />