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_ 1♦ 1♦ 1♦ "85 Ja Dri Morgan Ill,Cr 037 OB)7�600� (4782-63081& _ <br /> UOIA ANALYTICAL ❑ 1455 McDowe , Suite D • Petaluma, CA 94954• (707)792-1865 . FAX(707 -0342 <br /> Q 819 Striker Ave , uite 8 • Sacramento, CA 95834• (916) 921-9600 • FAX (916) 921-0100 <br /> CHAIN OF CUSTODY ❑ 1551 Industrial Road • San Carlos, CA 94070 • (650)232-9600 + FAX (650)232-9612 <br /> ❑ 404 N Wkget Lane • Walnut Creek, CA 94598• (925)988-9600 • FAX (925) 988-9673 <br /> Company Name K. ,8 pp. c Project M2p &/A. S o,� _ CA-mR7 <br /> Mailing Address Billing Address (if different) <br /> City State (A Zip Code `)S'7 2- <br /> Telephone .0 2— Fax# P O # <br /> Report To Da E-mall Address rrlcr �( �,,,,QC Data evel li (standard) L3 Level III 13 Level IV <br /> Sampler Date/Time Results Required Sequoia's Work Order# <br /> Turnaround10-15 Working Days 1372 Hours MANDATORY NALYSES REQUESTED Please rovide method <br /> Time (Standard TAT) ❑ 48 Hours ❑ SDWA(Drinking Water) <br /> ❑ 7 Working Days ❑ 24 Hours fit- CWA(Waste Water) <br /> ❑ 5 Working Days ❑ 2-8 Hours ❑ RCRA(Hazardous W45te) <br /> ❑ Other <br /> ) 5 =5 <br /> YS� eaY 61 <br /> Client Date/Time Matrix #of Contj in�r� $equola's ,Q Comments! <br /> Sample I D Sampled Desc Cont T' Sample# �1' :;z Temp(If required <br /> 2 1 1 A17 I <br /> 4 <br /> 3 3 <br /> r <br /> 4 1 3� s <br /> 5 $0 ,Al 14 e s. i <br /> VC <br /> 6 /\ <br /> 7 ��yy <br /> Y t <br /> T ♦r i is �� r <br /> i <br /> 9 � C� i, Ki <br /> 10 A^.,, ?u r <br /> Relinquished By 3 -L7-D ReCpIved'By,. Date 1 Time ZZv <br /> Relinquished By 2- „ 3 //0 RereiVedBj KTCAA Date 1 Time <br /> FRlefin uished By Received By Date 1 Time <br /> Relinquished By Received By Date 1 Time <br /> Were Samples Received in Good Condition? ❑ Yes ❑ No Samples on Ice? © Yes ❑ No Method of Shipment Page of <br /> White Sequoia Yellow Sequoia Pink Client <br />