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ziQUOIA ANALYTICAL ❑ 819 WeAsiker Ave -Sacramento, CA 95834 - (916) 921-9600 FAX (9121-0100 <br /> ❑ 680 Chesapeake Drive- Redwood City, CA 94063 - (415) 364-9600 FAX(415) 364-9233 " <br /> qW CHAIN OF CUSTODY ❑ 1900 Bates Ave , Suite LM - Concord, CA 94520 - (510) 686-9600 FAX(510) 686-9689 <br /> FAdd <br /> mpany Name t _ w C S Protect Name ? f ,� u c - 7t <br /> resss r �� .T,,A,i -- Billing Address{ d drtferent) <br /> City `, C 7 „ State (:— 'A Zip Code 5 S <br /> Telephone 1/A/ `/ , CY 3 FAX# -V - `` P O # ! LD <br /> -l' U <br /> Re rt To J&;,f-r Sam ler _ w�,� j .�,r- ' <br /> Tumaround Tlme: Ur10 Working Days ❑ 3 Working Days ❑ 2-8 Hours Anal ses Re uested n <br /> ❑ 7 Working Days ❑ 2 Working Days <br /> ❑ 5 Working Days ❑ 24 Hours <br /> rt d <br /> Client Date/Time Matrix #of ContSequoia's N;� o <br /> Sample I D Sampled Desc Cant Type Sample# �U - Comments <br /> riATx 3 yon s3a361z6A' - <br /> r iSP <br /> 2 � - 3/�- 3 von /27 y G /u ? <br /> m <br /> Y <br /> 4 <br /> 5 <br /> 6 <br /> 7 5 <br /> 0 <br /> a <br /> 8 <br /> 10 <br /> Relinquished B�` ;/ Date 31sIy3 Time I SID Received By �, Dated ime j Z 3 S <br /> i <br /> Relinquished By Date Time Received By Date rime <br /> Relinquished By Date Time Received By Lab Date [rime <br /> Were Samples Received in Good Condition?0 Yes U No Samples on Ice9 ❑Yes❑No Method of Shipment Page�.of <br />