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`.. �QUOIA ANALYTICAL !D 680 Chesagke Drive • Redwood City, CA 94063 • (650) 364-9600 FAX (650)`��'`�-9233 <br /> czi1Ll 819 Striker Ave., Suite 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> iW CHAIN OF CUSTODY ❑ 404 N.Wiget Lane • Walnut Creek, CA 94598 • (510) 988-9600 FAX (510) 988-9673 <br /> Company Name:A �_ Project Name: �. _,lid <br /> t11.•,c.k Jf <br /> Address: �,yrir ts'� rev, `; - Billing Address (if different): <br /> City: 1 State:,.' Zip Code:�l �. <br /> � C p.�i <br /> Telephone:'%jt� _ �r/�i �, f FAX #: P.O.#: <br /> ef Report To:J ea v.`% ll Sampler: ( .� OC Data: ID'Cevel D (Standard) ❑ Level C EJLevel B ❑ Level A U <br /> Y <br /> Turnaround Lr�10 Working Days ❑3 Working Days ❑ 2 -8 Hours ❑ Drinking Water Analyses Requested <br /> d <br /> Time: ❑ 7 Working Days ❑2 Working Days ❑Waste Water (, <br /> ❑ 5 Working Days ❑24 Hours 8'0therc, V <br /> Client Date/Time Matrix # of Cont. Sequoia's ,�i <br /> Sample I.D- Sampled Desc. Cont. Type Sample # 'r Comments <br /> ck CA <br /> 4. <br /> 5. <br /> 6. <br /> 7. m <br /> 0 <br /> B. Cl) <br /> m <br /> 9. t <br /> 10. <br /> Relinquished B f �.. �� Date Time: 1 ,:,'� ca Received B . / "' ' Date: Time: = <br /> q y � i > x - :61��� y tl 'r. - <br /> r- y` <br /> S 6 <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? P-Yes ❑ No Method of Shipment !i }r�, I. Page of <br />