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r M I <br /> UOIA ANALYTICAL ❑ 680 Chesapeakee• Redwood City, CA 94063• (650) 364-9600 FAX (650) 364-9 <br /> ❑ 819 Striker Ave , 5 e 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> CHAIN OF CUSTODY ❑ 404 N Wiget Lane •Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 <br /> ❑ 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> Company Name TC � r Project Name k -2-s` r 7�F�c3 <br /> Mailing Address tt 17Billing Address (if different) <br /> City r� State Zip Code 25-3-5t <br /> Telephone �t FAX # Z6q-5?7- ZZZs— PO # <br /> [Reort To �2�4 �-o Sampler Altx F10-cc S QC Data Level D (Standard) ❑ Level C © Level B ❑ Level A U <br /> Y <br /> Turnaround X10 Working Days ❑3 Working Days ❑2 -8 Hours ❑ Drinking Water Analyses Requested _ <br /> Time ❑ 7 Working Days ❑2 Working Days ❑Waste Water <br /> ❑ 5 Working Days O 24 Hours yc�l�/ agther C, <br /> Client Date/Time Matrix # of Cont Sequoia's <br /> Sample I D Sampled Desc Cont Type Sample # Comments <br /> 1 M11� O�xf4 <br /> oz W 3 SIO M 0/ <br /> ✓ <br /> 0 <br /> or <br /> 2 74F of <br /> 3 oto3oqq I& W 1a S <br /> 0 <br /> 4 <br /> 5 <br /> 6 <br /> 7 m <br /> 0 <br /> Cr <br /> $ a) <br /> U) <br /> 9 t <br /> 10 <br /> Relinquished By L-4— Date 07 o I Time )SW Received B Date Time 3C z <br /> Relinquished By e Date 0,7-a/- Time Y-clr Received By Date Time <br /> Relinquished By Date Time Received By Lab Date Time <br /> 'Were Samples Received in Good Condition? ❑Yes 0 No Samples on Ice? t2'�es ❑ No Method of Shipment C001-r'41� Page of <br />