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❑ 885 Jarvis Drive • Agan Hill, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 e <br /> S OIA ANALYTICAL ,;K-&19 Striker Ave., 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-010JI) U 404 N.Wiget Lane • alnut Creek, CA 94598 • (925) 988-9600 FAX (925) 9B8-9673 <br /> CHAIN OF CUSTODY U 1455 McDowell Blvd. North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> L] 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 ' <br /> f' <br /> Company Name:A�-� _ 1 - —_ Project Name: �?_ <br /> Mailing Address: //1 L / Billing Address (if different): <br /> --- c.1Y1G to i» �IJ� _ _lfi�t��fz�-� <br /> City: ,+ ' . State: Zip Code:g <br /> Telephone: 20"1-5,101 �z z 1 FAX #: zap- �9- 222 S Po. #: <br /> Report To: Sampler:T' QC Data: �eva (Standard)l D (Stdd) C1 Level C ❑ Level B ❑ Level A U <br /> }c f`��r�s Y <br /> Anal ses Re uesied <br /> 'Turnaround .Zt'$O Working Days U 3 Working Days U 2 - 8 Hours Q Drinking Water y qCL <br /> Time: U 7 Working Days U 2 Working Days Q Waste Water <br /> L1 5 Working Days ❑ 24 Hours >otherC,l t(/ <br /> Client Date/Time Matrix # of Cont. Sequoias <br /> Sample I.D. Sampled Desc. Cont. Type Sample # �' Comments <br /> t!I, ` <br /> 1. ✓ <br /> _1v���- a�Sao �3 ``� l �_ ---- -- 0 <br /> .o <br /> 6 <br /> (D <br /> 2. - U) <br /> 3. <br /> r <br /> 4. <br /> 5.__T — - <br /> 6. <br /> 7. o <br /> a' <br /> m <br /> n� <br /> 9. <br /> _71 id. <br /> RelinquishedBy: it l f �L � Date: Time: Received By: Date:(d - Time: t �� <br /> Relinquished By: ate. Time: Received B DateTime: (J L© <br /> Relinquished By: Date: Time: Received By Lab: Date: Time: <br /> Were Samples Received in Good Condition? U Yes U No Samples on Ice? Yes U No Method of Shipment_. ��Li�'l�.,F� Parte j of <br />