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QA01OIA ANALYTICAL ❑ 680 Chesape&Drive • Redwood City, CA 94063 • (650) 364-9600 FAX (650) 36 33 ti4 <br /> 01 ❑ 819 Striker AMWSuite 8 • Sacramento, CA 95834• (916) 921-9600 FAX (916) 9210 ' w+ <br /> 4W CHAIN OF CUSTODY ❑ 404 N.Wiget Lane • Walnut Creek, CA 94598• (510) 988-9600 FAX (510) 988-9673 <br /> Company Name: ATG ksso ',,c4,e Project Name;.gOSQ S0. !72 2 . 4002_ <br /> Address: ( 11 j -0ne `p0. A\Je- �A Billing Address (if different): <br /> City: State: C", Zip Code: C5 1 <br /> i r; <br /> Telephone: FAX #: P.O. #: <br /> 2.(1q-5 q-zzzI 5�`9-222'5 <br /> Report To T u Sampler: �1�)t � r QC Data: evel D (Standard) C] Level C ❑ Level B \0 Level A v <br /> Turnaround 10 Working Days ❑3 Working Days ❑2 - 8 Hours ❑ Drinking Water I Analyses Requested E- <br /> a. <br /> Time: © 7-Working Days ❑2 Working Days ❑Waste Water o _LcQ <br /> ❑ 5 Working Days ❑24 Hours 0&ther <br /> Client Date/Time Matrix # of Cont. Sequoia's Comments <br /> Sample I.D. Sampled Desc. Cont. Type Sample # n7 ( ':a <br /> 1. M — -72 wo ,� r L <br /> 0 <br /> 3 <br /> Cr <br /> 2 cn <br /> i <br /> 3 <br /> 3. o <br /> 4. <br /> 5. <br /> 6. <br /> m <br /> 7. o <br /> Cr <br /> aD <br /> 8. <br /> m <br /> 9. <br /> 10. <br /> Time: /py9 Received By: / 21 Date: ,��. "�' Time: <br /> Relinquished By: � ��.y Date:uTx9� � •� , , � <br /> Relinquished By: �% Date: � � Timet Received B Date;�r ` Time: <br /> Relinquished By: Date: Time: Received•By-t=ats: �- Dater Time: r, <br /> Were Samples Received in Good Condition? ❑Yes ❑ No Samples on Ice? Wes ❑ No Method of Shipment (!00r-;e_r Page of L <br />