Laserfiche WebLink
-41OUOIA ANALYTICAL Chesa*e Drive• Redwood City, CA 94063• (650) 364-9600 FAX (650)9233 <br /> _ ❑ 819 Striker Ave , Suite 8 • Sacramento, CA 95834• (916) 921-9600 FAX (916) 921-0100 <br /> CHAIN OF CUSTODY ❑ 404 N Wiget Lane• Walnut Creek, CA 94598• (510) 988-9600 FAX (510) 988=9673 <br /> Company Name � �� Protect Name r ! <br /> S <br /> Address �� VC/ S Billing Address (if different) <br /> CityeS State Zip Code 95 <br /> w <br /> Telephone FAX# -5 _ PO # <br /> Report To Sampler, QC Data ❑ Level D (Standard) ❑ Level C ❑ Level 8 ❑ Level A U <br /> Tf ve <br /> Re <br /> Turnaround Working Days ❑3 Working flays ❑2-B Hours El Drinking Analyses Requested Lnking Water Y q � <br /> Time ❑ 7 Working Days ❑2 Working Days ❑Waste Water <br /> ❑ 5 Working Days ❑24 Hours Q-6her _ <br /> Client Date/Time Matrix #of Cont Sequoia's4,} Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> 1 Mvi 3 �b7T8 a 1 .3 y D , LV <br /> 0 <br /> 6 <br /> 2 v��• � �02o r� 3 N .J <br /> 3 ' <br /> 0 <br /> _ a <br /> 5lip- <br /> - <br /> I _ p <br /> ' 4 <br /> 7, ~ � �b l 5 � 1 = 4Y 3 O <br /> {l <br /> U W <br /> 8 - rn <br /> 9 _ <br /> 10 " <br /> Relinquished By /tt..4..'7.- ate Time Received By Date /C-I,,- Time a <br /> Relinquished By, Date Time Received By Date Time <br /> i <br /> Relinquished By-' Date= Time Received By Lab Date Time <br /> Were Samples Received in Good Condition? El Yes 0 No Samples on Ice'? C+�Yes 0 No -� Method of Shipment Page of <br />