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SEb O1�'► A L Ti�A� ou�flesapCdKe Re ivG nrvud Ci y, v 4 ao4 9 �� FAX 4�a 36 y��3 <br /> ❑ 819 Striker Ave:, Suite 8• Sacramento, CA 95834• (916) 921-9600 FAX (916) 921-0100 s RAS <br /> Vw CHAIN OF CUSTODY ❑ 404 N. Wiget Lane • Walnut Creek, CA 94598 • (510) 988-9600 FAX (510) 988-9673 <br /> Company Name: D -h c Project Name: D <br /> Address: Billing Address (if different): <br /> City: State: Zip Code. <br /> Telephone: FAP.O. #: <br /> A) <br /> lReport To. Sam ler: QC Data: ❑ Level D(Standard) ❑ Level C ❑ Level B ❑ Level A v <br /> Y <br /> Turnaround; ❑ 10 Working Days ❑ 3 Working Days ❑ 2 - 8 Hours ❑ Drinking WaterAnal ses Requested_ a <br /> Time: ❑ 7 Working Days 1:12 Working Days ❑ Waste Water c!� <br /> ❑ 5 Working Days ❑ 24 Hours ;�ZC) f �7 '54 Other C <br /> Client Date/Time Matrix #of Cont. Sequoia's <br /> Sample I.D. Sampled' -Desc. r Cont. - Type Sample# � - - - Comments- <br /> 1 '�11 !Z 2. ILI <br /> z�r� VOACr <br /> 3. <br /> } <br /> 4. <br /> 5. <br /> - __ <br /> 6. - <br /> 7 <br /> 0 <br /> rr <br /> 8. ) <br /> m <br /> 10. <br /> Relinquished By: Date._- Times CO Received By: Date: Time: <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> Relinquished By: Date: Time: Received By Lab: Date: ime: <br /> Were Samples Received in Good Condition?0 Yes❑ No Samples on Ice? 0 Yes 0 No Method of Shipment D Page_f of <br />