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M M = to = M MM = M = M = Wo" - = <br /> 4 SEQUOIA ANALYTICAL ❑ 885 Jarvis Drive • Morgan Hili, CA 95037 * (408)776-9600 * FAX (408)782-6308 <br /> Ll 1455 N McDowell Blvd, Suite D * Petaluma, CA 94954+ (707)792-1865 * FAX(707)792-0342 <br /> CHAIN OF CUSTODY L3819 Striker Ave , Suite 8 + Sacramento, CA 95834* (916)921-9600 + FAX(916) 921-0100 <br /> wo <br /> 404 N Wiget Lane + Wainut Creek, CA 94598+ (925)988-9600 * FAX(925) 988-9673 <br /> Company Name �Te SO(LQb N 5, 1 NC, Project N JoAQul N <br /> Mailing Address 15'-75- A LV R. 50t 12— Billing Address(if different) <br /> City LAIAL GHEE State Cft Zip Code 9q.52 g <br /> Telephone ME) 91 Y—2_&0Q Fax# iJ p P0 # .V 1'7. W 1. 0 o©2.. <br /> Report To k Cfi 1E L-5 E-mail Address QC Data Leve! II (standard) ❑ Level !ll Cl Level{V <br /> Sampler KAA c4k E 4 K Date 1 Time Results Required Sequoia's Work Order# L�(z <br /> Turnaround )( 10-115 Working Days ❑ 72 Hours MANDATORY, ANALYSES REQUESTED Please Drovide method <br /> Time (Standard TAT) ❑ 48 Hours ❑ SDWA(Drinking Water) <br /> ❑ 7 Working Days ❑ 24 Hours ❑ CWA(Waste Water) <br /> O 5 Working Days ❑ 2-8 Hours ❑ RCRA(Hazardous Waste) <br /> Other M0gK0_P X16 W� <br /> i <br /> Client Date 1 Time Matrix #of Contamer Sequoias Q� �$� Q� �� �]� Comments► <br /> Sample I D Sampled Desc Cont Type Sample# �� ' ` Tem It required) <br /> 1 NI In/ 9 I2II6/oy to fs W 3 lOn,L. VIA a 01 ✓ �/ ROS 1�� <br /> 2 MW-7 I2/,bJoy i f q0 W 3 0' V ✓ G��� <br /> 3 —TANK rW alaW 1235 W! 3 0s , V V ✓ ✓ ✓ ✓ V <br /> WA Izl16/ol 1 q30 W -3 ✓ V <br /> 5 MW-6 12116/0 1535 W 3 Q's V <br /> 6 M W- 11/14/04 1720 W V V <br /> 7_ M W-3A 1211-710 0800 W 3 07 V V <br /> 8 M W- ZA 12-/17l04 1005 W 3 og V v <br /> 9 M W--Z 12/11184 1035 Uel 3 pcf V L/ <br /> 10 MW—ZD 19-/I7/eq loqc W 3 !ib ✓ ✓ 15 <br /> Relinquished by 1 Co ,.� Received by 1 Co Date 1 Time 1 Temp I 111-6b 30 <br /> Relinquished by/Co Received by 1 CoDate 1 Tlme!Temp (j <br /> Relinquished by!Co Received by 1 Co Date 1 Time 1 Temp u i <br /> Relinquished by I Cc Received by 1 Co Date 1 Time I Temp <br /> Were Samples Received G ondibon? ql�_Yes O No Samples on Ice? K'Yes ❑ No Method of Shipment Page of I <br /> White Sequoia Yellow Sequoia Pink Client <br />