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UOIA ANALYTICAL Chesapeake • Redwood City, CA 94063• (650) 364-9600 FAX (650) 364-CS <br /> ❑ 819 Striker Ave , quite 8• Sacramento, CA 95834 . 916 921-9600 FAX 918 921-0100 <br /> 4D- CHAIN OF CUSTODY ❑ 404 N Wiget Lane•Walnut Creek, CA 94598• (925) 988-9600 FAX (925) 988-9673 <br /> ❑ 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> Company Name ATC S IvNc. Project Name t1Qor% <br /> fl 13098 I Quo 1 <br /> Mailing Address 111-7 Lone. "RQ1w, Ave. Su i a Billing Address (if different) <br /> City mod es�o State Zip Code <br /> Telephone 2.M-579- FAX # Z09—579- PO # <br /> Report To Dre„vi Va,, N 1 ul Sampler Me/ �j res I QC Data Zevel D (Standard) ❑ Level C ❑ Level B ❑ Level A v <br /> Turnaround &100"Working Days ❑3 Working Days ❑2 -8 Hours ❑ Drinking Water Analyses Requested <br /> Time ❑ 7 Working Days ❑2 Working Days Xt <br /> ste Water <br /> ❑ 5 Working Days ❑24 Hours er 4 <br /> Client Date/Time Matrix #of Cont Sequoia's �fu� 4� Comments <br /> Sample I D Sampled Desc Cont Type Sample # +� <br /> 1 Mw-- 1 060119 JOD W �� +ur,5� ✓ t/ <br /> 2 Mk4J- Z I15Cr <br /> 3 PAUL-3 o <br /> } <br /> 4 <br /> 5 <br /> 6 <br /> 7 c� <br /> 0 <br /> 8 W <br /> m <br /> 9 t <br /> s � <br /> 10 <br /> Relinquished By ,, Date b Time Received By f r Date C I^ Time <br /> I } <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time ����Received By Lab Date Time <br /> Were Samples Received in Good Condition? ❑Yes ❑ No Samples on Ice? �'es ❑ No Method of Shipment Court e'vo, Page of <br />