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I♦ � Creak e • �oocM CAM3 • W 36z=0 F�50)��� <br /> OUOIA ANALYTICAL ❑ 819 Striker Ave e 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 92i-0 <br /> ❑ 404 N Wiget Lan •Walnut Creek, CA 94596 • (925) 988-9600 FAX (925) 986-9673 <br /> CHAIN OF CUSTODY ❑ 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> 0 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Company Name A) Project Name F-� <br /> Mailing Address L o Yy v� j�_ra '4J Billing Address (if different) <br /> City �� I� Slate Zip Code C,6-3y <br /> Telephone Z�� f} Z I FAX # �� ZZZ 1 PO # T <br /> Report To ��� � N a 1� Sampler Ak R, , QC Data +Level II (Standard) ❑ Chromatograms ❑ Level III ❑ Level IV v <br /> Y <br /> Turnaround vandard ❑7 Working Days ❑2 Working Days ❑ Drinking Water Analyses Requested <br /> 10-15 <br /> Time EJ Working Days 5 Working Days LJ1 Working Day C11�jhaste Water <br /> ❑3 Working Days U ASAP �ther , <br /> Client Date/Time Matrix # of Cont Sequoia's �� `` Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> CY <br /> 2 AN VA tk(1 <br /> /U� t �i� J l� a <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> m <br /> 7 0 <br /> 0- <br /> (1) <br /> 8 U' <br /> a� <br /> 9 <br /> 10 -J- I <br /> Relinquished By V /��f Date y Time (, Received By Date Time <br /> Relinquished By Date SY_ < Time Received By Date Time <br /> Relinquished By Date Time Received By Late Date Time <br /> Were Samples Received in Good Condition? 0 Yes ❑ No Samples on Ice? 0 Yes U No Method of Shipment Page of <br />