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SEQUOIA ANALYTICAL "0 Chesapeake Drive - Redwood City, CA 94063 - (650) 364-9600 FAX (650) 364-9233 <br /> ❑ 819 Striker Ave., Suite 8 • Sacramento, CA 95834 - (916) 921-9600 FAX (916) 921-0100 <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: h`r �e Project Name: ,, -7,, <br /> Mailing Address: IM Lorjt�yl, Billing Address (if different): <br /> City: hit 0&e5.a State: Zip Code:It <br /> Telephone: FAX #: ✓.r._zy°7y- P.O. #: <br /> Report T� Sampler•: �' QC Data: p'tevel D (Standard) ❑ Level C ❑ Level 8 CJ Level A v <br /> �' '� <br /> Turnaround0 Working Days ❑3 Working Days ❑ 2 - 8 Hours ❑ Drinking Water Analyses Requested <br /> CL <br /> Time: U 7 Working Days ❑2 Working Days ❑W�aste Water <br /> Q 5 Working Days 0 24 Hours q Wq i <br /> Client Date/Time Matrix # of Cont. Sequoia's Comments <br /> Sample I.D. Sampled Desc. Cont. Type Sample It 1L <br /> j4 V <br /> V <br /> 2. (Y\V�. (,1 V ✓ W <br /> to <br /> 3. i V1w' ' t Z`� ✓ ''� ✓ o i <br /> 4 } <br /> 5. <br /> 6. <br /> 7. <br /> ro <br /> 0 <br /> 8. <br /> Q) <br /> 10. <br /> F-- <br /> Relinquished By: A -7A- LA4,j Date:6330Q') Time: Received By: .y DateLS-,3, Time:/G v <br /> Relinquished By: st,-z �r Date:3 l� Jy Time: Received By: Date: Time: f� <br /> Relinquished By: ' ' Date:•��.3 Time: Received By Lab: Date: Time: <br /> r� <br /> Were Sampleeived in Good Condition? U Yes U No Samples on Ice? r s �C] No Method of Shipment_ ; / _ Page r• <br />