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Chesa <br /> ea ;ve -, Redwood City, CA 9406 <br /> OUOIA ANALYTICAL �8g Striker pA a ste 8 Sacra ento, CA 9 834• (9616))9261496000 XX <br /> iz_ (9116)9264 <br /> � CHAIN OF CUSTODY ❑404 N Wiget Lane •Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 j <br /> ❑ 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> Company Namelar` p+sSOCAQAe r)( _ Protect Name � � �r s�S k l R Sy4 2 S P4.oc,ol <br /> Mailing Address JVJ*7 L.OVNz. Billing Address (if different) <br /> City M State (�, Zip Code gS351 <br /> Telephone UI-579,7ZZ FAX # 209-671-ZZZ5 PO # a) <br /> Report To h Sampler 41exS QC Data iWevel D (Standard) ❑ Level C ❑ Level B ❑ Level A v <br /> Turnaround *10 Working Days U 3 Working Days 012 -8 Hours ❑Drinking Water Analyses Requested <br /> Time U 7 Working Days U 2 Working Days L1 Waste Water <br /> C35 Working Days U 24 Hours t/Other G W <br /> Client Date/Time Matrix # of Cont Sequoia's <br /> Sample 1 D Sampled Desc Cont Type Sample # AID Comments <br /> ILS <br /> .J 906-1061 . ✓ �' .� Lz <br /> 0 <br /> 2 VJ-Z 0 2 991 131 906106 f/ ,� W <br /> 3 Mw-3 13 9061.06 <br /> 4 M�►J- R 13-3 ow,0p6.7 '� ✓ <br /> 15 . <br /> 5 MUJ_5 5 90caos <br /> 6 M►+ .5 go(;I,O(;!* <br /> 7 <br /> 0 <br /> 8 <br /> 9 L <br /> 10 <br /> Relinquished By e -F�tRN DateV60 Tee / Z Received B �Jc Date v(QUf Time , Y <br /> 7 <br /> Relinquished By Date monc, Time/ Received By Date ����� Time <br /> i <br /> Relinquished By Date�� Time Received By Lab Date b Time <br /> Were Samples Received in Good Condition? 'J Yes U No Samples on Ice? fes U No Method of Shipment OArlr'f'4Ar Page JL of <br />