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MI <br /> 1C- U <br /> OIA A�IALYTICAI 684 Ches:Iet <br /> Drive • Redwood City, CA 94063 • (415) 364 9600 FAX (41 -9233 <br /> ❑ 819 West r Ave • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 1_0100 <br /> . <br /> CHAIN OF CUSTODY ❑ 1900 Bates Ave , Suite LM - Concord, CA 94520 • (510) 686-9600 FAX (510) 686-9689 <br /> Company Name AtJST Q,S Project Name Qu i� S i !'3Z F']r 3Z,Q3 <br /> Address 33 v 5 A(--A M ADE t� CN t Q-:,-6 n) Sv i C/ <br /> Billing Address { rf different) Sit �1 Lrj Q S I + <br /> City '40 State C. Zip Code `A 95 1 �Q. li.t Oti`i '�fi 146 " <br /> C <br /> Tele hone Lion N FAX# 4 01) P 0 # <br /> U <br /> Re rt To ?,%Uk LIpV- rJ Sam ler '� ( UR OG Data Level A(Standard) ❑ Level B ❑ Level C ❑ Level D <br /> Turnaround *0 Working Days ❑ 3 Working Days ❑ 2 -B Hours ❑ Drinking Water [Analyses Re uested a. <br /> Time. ❑ 7 Working Days ❑ 2 Working Days ❑ Waste Water <br /> ❑ 5 Working Days ❑ 24 Hours ❑ Other <br /> L� <br /> Client Datefrime Matrix #of Cant Sequoia's /4W <br /> c`'j- �� Comments <br /> Sample I D Sampled Desc Coni Type Sample# �Q <br /> �1 to <br /> 2 <br /> o <br /> 3 ►JItJ'-- Z ,ti �S o <br /> r <br /> 5 mow• ti as x <br /> 6 VA LJ ti• o 3 <br /> 7 <br /> CD <br /> 8 N <br /> m <br /> 9 s <br /> 10 <br /> Received B Date /1/z ime /n <br /> Relinquished By Date IL 2a 13 Time f� r�• Y <br /> - <br /> Relinquished By G Date Time �1 /U Receive y Date /Z Z► j rme 9 <br /> Relin uis B <br /> f Date 1 Z al Time 'Za Received B Lab Date J-2 r ime 7_0 <br /> Were Samples Received in Good Condition?❑Yes U No Samples on Ice? U Yes ❑No Method of Shipment' <br /> Page_of <br />