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'� ' r �' �_1�� �_ _-. L.1 VVJ 11111 VIJ-M•I V�` -.411 -J., A- '}1t�.i'�, i i��.: -?.... �"' ,.-1� ..... .,1:.- -.h.�-•.� - � ' �.S <br /> )EQUOIA ANALYTICAL El 1455 McDowell,"'-'V. North, Suite D •Petaluma, CA 94954• (707) 792-1865 • FAX 792.0342 <br /> ❑819 Striker Ave., _bite 8•Sacramento, CA 95834• (91 6) 921-9600• FAX (9 16) 92't 0 <br /> 1551 9 San Carlos, CA 94070 232-9600 • FAX 650) 232-9612 <br /> CHAIN OF CUSTODY p 404 NnWigert Lane ial tl { <br /> Walnut Creek, CA 9a 98• (9 5) ( <br /> ) 988-9600• FAX (925) 988-9673 <br /> Project: <br /> Company Name: Qx- ��• �j ,i �.] <br /> Mailing Address: � 1 �re C,- tiv 'AE.- Z Billing Address (if different): <br /> City: �,����C r¢ I� <br /> State: L Zip Code: a���, c <br /> Telephone: yS d 7,rS Fax#: P.O. #: U <br /> Report To: 1Gl.� LeV, ne E-Mail: QC Data: C3 Level II (Standard) ❑ Level ill ❑ Level IV = <br /> Sequoia's Work Order# l � CL <br /> Sampler: � V,AC113--,e)Pf Date/Time Results Required: q � <br /> 10 <br /> Q>L <br /> MANDATORY: ANALYSES REQUESTED (Please provide method) <br /> Turnaround - 15 Working Days ❑ 72 Hours <br /> Time: (Standard TAT) ❑ 48 Hours D SDWA(Drinking Water) <br /> ❑ 7 Working Days ❑ 24 Hours ❑ CWA(Waste Water) <br /> ❑ RCRA Hazardous Waste) ,�,� Comments! <br /> O 5 Working Days ❑ 2-8 Hours (Hazardous �� <br /> 9 Y a Other WiF \/5Kiz 7? �` ��Q Temp.(Il required} <br /> Client Date/Time Matrix # of Container Sequoia's <br /> Sample I.D. Sampled Desc. Cont. Type Sample# K.t� o <br /> .o ' ► b ill �u ^44-v i l D 1 4��- Cr <br /> 1. 'rn� •- 12, <br /> J t <br /> Vj �d M L VIS <br /> ani �r ( w �J rK d t fi-- 03 <br /> 3. �/�/ -Z� <br /> ,�'ii �► 3 s� U4 x `� 'C <br /> 4. V\/ — Z /L '� z I, vr ti, <br /> 5: E� -- 1 _,� Inc v � Q <br /> Cr <br /> 6. �n <br /> 7. <br /> L <br /> S. <br /> 9. <br /> 10. <br /> Relinquished By: Received By:, . . r Date 1 Time: 117/12 -V! 0, S <br /> Relinquished By: Received By: Date/Time: <br /> Relinquished By: Received By: Date 1 Time <br /> Relinquished By: Received By: Date/Time: <br /> Were Samples Received in Good Condition? o Yes 0 No samples on Ice? ❑ Yes 0 No Method o1 Shipment_�_ Page of <br />