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µ <br /> V6UOIA- <br /> A80 80 Chesapeakove• Redwood City, CA 94063 • (6�0) 364-9600 FAX (650) 364-4 <br /> ANALYTICAL ❑819 Striker Ave , Suite 8 • Sacramento, CA 95834• (916) 921-9600 FAX (916) 921-0100 <br /> A-W 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 • Pe luma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> Company Name Project Project NameWtlnee, %,evr k%2. GX54 b O <br /> Mailing Address Billing Address (if different) <br /> City hiate Zip Code !:115 <br /> TeEephone FAX # Z011-S79--ZZ�5 PO # T <br /> a� <br /> -rRepor1T0 .A4gaV%V.,4LSampler A Set x Tio-rcs QC Data Vevel D (Standard) ❑ Level C ❑ Level B ❑ Level A U <br /> Turnaround o Working Days ❑lWorking Days ❑2-8 Hours ❑ Drinking Water Analyses Requested <br /> Time ❑ 7 Working Days ❑2 Working Days ❑Waste Water - <br /> ❑ 5 Working Days ❑24 Hours Wo6ther <br /> r Client Date/Time Matrix # of Cont Sequoia's Q _ ` <br /> Sample I D Sampled Desc Cont Type Sample # Comments <br /> o 0A 's <br /> 1 MW-1 <br /> 0 <br /> 2 - Z 1140v <br /> �_- U) <br /> 4tr f 155 <br /> atk x r <br /> i <br /> 55 <br /> f <br /> � Y ' �Yr 3'�T <br /> 7 0 <br /> ti + j 3 <br /> t <br /> EE '' 4 f <br /> LJ i i a ! 1 _! t_ .� w C'- <br /> 8 <br /> W <br /> 9 +. <br /> L <br /> 110- <br /> Relinquished <br /> 0'Relinquished By ' Dated g Time f Received By -W/yJ y �� Date Z _ Time <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By _Date Time Received By Lab Date Time <br /> I <br /> Were Samples Received in Good Condition? ❑Yes ❑ No Samples on Ice9 ErYes ❑No Method of Shipment 1.10mlex Page 4-of <br />