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t <br /> r r <br /> edwood <br /> ,!D S UOIA ANALYTICAL �g StrikerpAve k, S�8 RSacramentCity, <br /> o, CA 954834 • (9616))921-96006 0 FAXFAX <br /> (9116) 926--01000, <br /> 1W 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 • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 _ <br /> Company Name A i S Project Name 41 j ,r� <br /> Mailing Address 11 So} Billing Address (it different) <br /> City m O Ck eS State Ca, Zip Code 1153S- 1 <br /> Telephone � - ?„ Z 2 Z FAX # 24CA_ 5 7 - ZZ P0 # <br /> Report To �� Va, +Al(e,4,. Sampler *¢), QC Data Oeevel D (Standard) ❑ Level C LlLevel B ❑ Level A v <br /> .,��1/ Y <br /> Turnaround X10 Working Days ❑3 Working Days ❑2 - 8 Hours ❑ Drinking Water Analyses Requested <br /> Time ❑ 7 Working Days ❑2 Working Days ❑Waste Water <br /> ❑ 5 Working Days ❑24 Hours Other <br /> Client Date/Time Matrix # of Cont Sequoia's jy� Comments <br /> Sample I, D Sampled Desc Cont Type Sample # <br /> 1 MW— 1GS T <br /> Cr <br /> 2 MW• z 1�1'� V <br /> 4 <br /> 5 <br /> 6 <br /> 7 0 <br /> Cr <br /> 8 ) <br /> a� <br /> 9 <br /> 10 <br /> Relinquished By . .t� yv C�:.�.i�. " Datq,7 l'�� Time 4'17 Received By e,'j �1`1a� —3 Date Time <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? &IYes ❑No Method of Shipment� n�r—E e A& Page of <br />