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4l A4114 L iIV— i44V.Uµll ill, yUJd i Vj V 11W ! '0u1 I Jt .,J1i <br /> SE UOIA ANALYTICAL El 1455 McDowell Blvd, Suite D • Petaluma, CA 94954 • (707) 792-1865 • FAX (707) 792-0342 <br /> Q ❑ 619 Striker Ave , Suite 8 • Sacramento, CA 95834 • (916) 921-9600 • FAX (916) 921-0100 <br /> aCHAIN OF CUSTODY El1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 • FAX (650) 232-9612 <br /> 1W 9 404 N Wiget Lane • Walnut Creek, CA 94598 • (925)988-9600 + FAX{925)988-9673 <br /> Company Name Project -NA <br /> Mailing Address 15-TT LbF :3141 ZI Z Billing Address (if different) <br /> City 6x r A- t ee�- State [ Zip Code <br /> Telephone S- p S0 Fax# P 0 # <br /> Report To i f< <w L2., Ae- E-mail Address ft r1 tC� .,tee at ,^;f QC Data ❑ Level I1 (standard) ❑ Level III ❑ Level IV <br /> Sampler ,LP—,l ,.e G 9ef Nt,, Date !Time Results Required Sequoia's Work Order# <br /> Turnaround g 10-15 Working Days ❑ 72 Hours MANDATORY ANALYS S REQUES e method) <br /> Time (Standard TAT) ❑ 48 Hours ❑ SDWA(Drinking Water) <br /> ❑ 7 Worsting Days ❑ 24 Hours a CWA(Waste Water) <br /> ❑ 5 Working Days ❑ 2-8 Hours ❑ RCRA(Hazardous Waste) <br /> ❑ other <br /> i <br /> Client Date 1 Time Matrix #of Container Sequoia's Comments/ <br /> Sample I D Sampled Dese Cont Type Sample # Tem If required) <br /> 1 Vll L 02 2 fN vomc- <br /> Vo 0- DIA-c— <br /> 2 G/1�I ZIPS, 6 fit/ I vl .3 LA <br /> j� <br /> 4nW "� a ` �� w yvµ 04 <br /> �aM44 ' <br /> 6 A � <br /> A 7,2id 0 yd's <br /> ' 2rlV <br /> 7 N14'V' bS/J 30d vM <br /> a ,r <br /> L <br /> 10 �F' of 3 VL) <br /> Relin uished_By I&A I .< Received By Date/Time <br /> Relinquished By Received By Date /Time <br /> kelin uished By Received By Date /Time <br /> Relinquished By Received By Date /Time <br /> Were Samples Received In Good Condition? ❑ Yes ❑ No Samples on Ice? ❑ Yes ❑ No Method of Shipment Page of <br /> White Sequoia Ye.Sequoia Pink Client • <br /> ....� �� �..� a>r� � �r ii_ s� sill» i• 1s i• � � � � � � S <br />