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❑ 885 Jarvis,DnVe • Morgan Hill, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 <br /> El819 Striker Ave , Suite 8 • Sacramento, CA 95834• (916) 921-9600 FAX (916) 921-0100 <br /> SEQUOIA ANALYTICAL <br /> ❑ 404 N Wiget Lane -Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 <br /> Wo CHAIN OF CUSTODY ❑ 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> ❑ 1551 Industrial Road • San Carlos, CA 94070• (650) 232-9600 FAX (650) 232-9612 <br /> Company Name t, _ -,, � -` Protect Name <br /> Mailing Address f �/ 'f, - r j,, fes_ Billing Address (if different) <br /> City ,` State Zip Code <br /> Telephone ---,; FAX # PO # <br /> Report To , f Sampler OC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A U <br /> Turnaround p 10 Working Days ❑3 Working Days ❑2 - 8 Hours ❑ Drinking Water Analyses Requested <br /> Time ❑ 7 Working Days ❑2 Working Days ❑Waste Wafer ,l <br /> IL <br /> ❑ 5 Working Days ❑24 Hours ❑Other <br /> Client Date/Time Matrix # of Cont Sequoia's Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> J ! <br /> n <br /> 0 <br /> Cr <br /> 2 .� f ' s t - .�' t tS4 m <br /> co <br /> 3 <br /> 0 <br /> 0 <br /> r <br /> 7 <br /> x <br /> 0 <br /> Cr <br /> 8 ,f. +� <br /> vwl <br /> Relinquished By 1�4 y-1 11 Dgle' Time ` .r Received By r� r <<`f f i Datei 3 Time ;k <br /> Relinquished By Date Time Received By Date Time <br /> Relin hed By Date Time Received By Date Tim <br /> low <br /> _Vere les ceded ii sd Cin? Ms 11IIIIIl1IIIIIIIIIl�arn♦n IIIIIIIIIIIIIIIIIIIIInri n�man� ♦ 1♦ <br />