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' YUOIA ANALYTICAL X000 Chesaps.:`;>..Drive • Redwood City, CA 54063 • (650) 364-9800 FAX (650) 36ti�?33 <br /> FJ 819 Striker A '' :Suite 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921=:�`4'�0 <br /> 1"r CHAIN OF CUSTODY ❑ 404 N.Wiget Lane • Walnut Creek, CA 94598 • (510) 988-9600 FAX (510) 988-9673 <br /> Company Name: AT(- ASS©G�a4-o—s jr:� Project Name: S��L,n S ren� �t a 7111, 0 o p'Z— <br /> Address: 12__bO r `GS Billing Address (if different): <br /> City: AAo C"+J State: — zip Code: 9535 f <br /> Telephone: r�_ S 7�_ ZZz FAX #: 20q—_-57t�_ ZZZ5 P.O. #: Q) <br /> Report To: Sampler: QC Data: W,6vel D (Standard) LJ Level C LJ Level B ❑ Level A C1 <br /> .�eAK�. C)V_,L5 i4mu d e s Y <br /> Turnaround UATWorking Days ❑3 Working Days U 2 - 8 Hours U Drinking Water Analyses Requested `��U �-� IL <br /> Time: U 7 Working Days 0 2 Working Days U Waste Water <br /> ❑ 5 Working Days ❑ 24 Hours Other <br /> Client Date/Time Matrix # of Cont. Sequoia's <br /> / / Comments <br /> Sample I.D. Sampled Desc- Cont- Type Sample # / / <br /> 1. <br /> w - Z- 072 02 _t� 0 <br /> 2. Mw+ 3 1030 Z- s5 �' ✓ Q <br /> 3. Mw - i ol0 �} ; ✓ o <br /> 4. <br /> 5. <br /> 6. <br /> 7. ra <br /> 8. 07 <br /> v <br /> 9. t <br /> 10. <br /> -.� Relinquished By: Date: Time: Received By: ',�; (22, 1:, �t!0i Date:'? z,i/q- Time �P <br /> Relinquished By: i C. �, 1G Date: ��_�� .i Time: i� Received By: --- Date_ Time: <br /> �`` �Uished t3y; Date: Time: Received By Lab: �f%C G i�� Date: �!! `!�r ' Time: 11J) <br /> in Good Condilion? U Yes U No Samples on Ice? U Yes U No Method of Shipment__-____-_ Page ___of__ <br />