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1 &UOIA ANALYTICAL 040 Chesapeake . <br /> Redwood City, CA 94063 • (650) 364-9600 FAX (650) 364-9� <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 • (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 ACr 4wia4m arlic Project Name, <br /> Mailing Address 1,1160 «S b f f Billing Address (if different) <br /> City 99�� State C Zip Code "361 <br /> Telephone -57 It. 2Z Z! FAX # 5 aZ�.S PO # - -- - - <br /> a� <br /> Report To Sampler Attx ores QC Data 011ffevel D (Standard) ❑ Level C ❑ Level B ❑ Level A U <br /> Tumaround 04, <br /> Working Days 3 Working Days ❑2-8 Hours ❑Drinking Water Analyses Requesteal <br /> 0- <br /> Time <br /> Time ❑ 7 Working Days ❑2 Working Days ❑Waste Water <br /> ❑ 5 Working Days ❑24 Hours 9,6ther <br /> Client Date/Time Matrix #of Cont Sequoia's <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> 3 <br /> 2 -M 1N fr r fr Y VN <br /> O <br /> I - <br /> co <br /> { I M l 1 1 <br /> I } 1 <br /> {{ i r <br /> ! T13 <br /> 8 t rn <br /> m <br /> 9 <br /> 10 <br /> Relinquished By Date jju Time Received By �//'11( Date `� ��� Time <br /> Relinquished By Date Time Received By Date Time <br /> 3 <br /> Relinquished By Date Time Received By Lab Date Time <br /> Were Samples Received in Good Condition? 0 Yes 0 No Samples on Ice? Sles 0 No Method of Shipment I Page of L <br />