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j fQUOIA ANALYTICAL ❑ 680 Chesapeak&ve • Redwood City, CA 94063 • (650) 364-9600 FAX (650) 364-� s, <br /> 0 819 Striker Ave , ite 8 - Sacramento, CA 95834 - (916) 921-9600 FAX (916) 921-Oi�� <br /> fid 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 hT e- Project NameS4pr kAPy% r <br /> 6L oao! <br /> Mailing Address t t-1 L�o r` a Billing Address (if different) ,r <br /> City State Zip Code �s351 qQ 7- 3 Y <br /> Telephone Z(A_ S7 _ -2-zZ FAX # 204-67$-Lt z.5 PO # <br /> (D <br /> Report Toe Sampler A OC Data E1evel D (Standard) ❑ Level C EJLevel B ❑ Level A U <br /> Y <br /> Turnaround t0 Working Days ❑ 3 Working Days ❑2-8 Hours ❑Drinking Water Analyses Requested <br /> Time ❑ 7 Working Days ❑2 Working Days ❑Waste Water d <br /> ❑ 5 Working Days ❑24 Hours ad'Other <br /> Client Date/Time Matrix # of Cont Sequoia's �-1 !1��' �� <br /> Sample I D Sampled Desc Cont Type Sample # W� �Q Comments <br /> l_ 0r+) 5j;57 <br /> 1 W 0700 <br /> 6 ! W i-oT 0/ V m <br /> 2 MW- 2 5 es ✓ ✓ <br /> co <br /> 3 Mw -3 d ✓ v <br /> Q <br /> 4 t�v�-y l�3 S ✓ ✓ } <br /> 5 M /3-0' � r ,� ✓ <br /> 6 RW — 11�� S 49 ✓ <br /> 7 v ver- l S 07- ✓ _� <br /> O <br /> 8 Y W-55 Icy D� ✓ ✓ ,/ 0 <br /> co <br /> 9 V vJ- 1430 s 9 ✓ ✓ <br /> ✓ L <br /> 10 <br /> Relinquished ByJt' Date 07011 Time /Z�RI Received B ate <br /> Y 7-�"� Time <br /> Relinquished By �7/ Date 07-" Time Received By at Time <br /> Relinquished By Date Time Received By Lab Date Time <br /> Were Samples Received in Good Condition? ❑Yes 0 No Samples on Ice) &,Ies ❑ No Method ofhipmen_de-oy�e_r Page—L of <br />