Laserfiche WebLink
M M M M M M M lA JaWrivergaMR, 037.19) 77 0 -M(40R%-631" <br /> JZ*QUOIA ANALYTICAL C] 1455 McDowell isNorth, Suite D - Petaluma, CA 94954- (707) 792-1865 - FAX (7092-0342 <br /> ❑ 819 Striker Ave , Suite 8 -Sacramento, CA 95834- (916) 921-9600 e FAX (916) 921-0100 <br /> 1W CHAIN OF CUSTODY ❑ 1551 Industrial Road - San Carlos, CA 94070- (650) 232-9600 - FAX (650) 232-9612 <br /> ❑ 404 N Wiget Lane-Walnut Creek, CA 94598&(925) 988-9600 - FAX (925) 988-9673 <br /> Company Name yypleo - GCo Cf q50,/ 7-r4V 7`S /r,/c' Project Z y Z /tom 57`6 C'/I . <br /> Mailing Address y?7 Up-7-6-g =1 Billing Address (if different) <br /> City M-T- V r G w/ State C_ Zip Code G: L/G'L/C,1 <br /> Telephone 6 S-� 112 '_U7 Fax# [� S GJ ZB ��S^�'l P 0 # v <br /> Report To Jo,-11,( 0`DOUk>t,-,.E-Mail QC Data ❑ Level i! (Standard) ❑ Level III ❑ Level IV Y <br /> C <br /> Sampler J 01 Date/Time Results Required Sequoia's Work Order # <br /> Turnaround X 10- 15 Working Days ❑ 72 Hours MANDATORY ANALYSES REQUESTED (Please provide method) <br /> Time (Standard TAT) ❑ 48 Hours ❑ SDWA(Drinking Water) <br /> ❑ 7 Working Days 0 24 Hours ❑ CWA(Waste Water) <br /> 0 5 Working Days 0 2-8 )"fours 0 RCRA(Hazardous Waste) ' 1�i �� Q� {��( comments/ <br /> ,U Other '\� \' \� \/ C Temp Of required) <br /> Client Date/Time Matrix # of Container Sequoia's <br /> Sample I D Sampled Desc Cant Type Sam le # <br /> v o <br /> uAi�Q G vi,¢�s ✓ ✓ ✓ <br /> 214q w - Z t � ,� �, L/ <br /> 3 <br /> 3 7 ✓ ✓ ✓ ✓ o <br /> 4 } <br /> 5 <br /> ro <br /> o <br /> 6 <br /> 7 <br /> 10 <br /> Relinquished By 3y � J Date/Time C( lc o <br /> �Anquished By f4 J,!J _ 4 3y (ti Date/Time IZ <br /> quished By ui �� blw, _ 5 iy Date/Time/ /� <br /> shed By Mev.-3 _ 3 y Date/Time <br /> 'eceived in Good Condition,7 0 Yes 0 No Samples on Ice? ❑ Yes ❑ No Method of shipment Page of <br />