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a*QUOIA ANALYTICAL Irl'80 Chesape4&rive • Redwood City, CA 94063 • (650) 364-9600 FAX (650) 3633 <br /> ❑ 819 Striker Ave , ufte 8 •Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> 1W 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 /4rc =i cQ -74- c . Project Nara rdny Z$$(,Ooc,3 -of <br /> Mailing Address ///7 Billing Address (if different) <br /> City.� State Zip Code 3_57 <br /> Telephone FAX # r ,.Z # <br /> Report To Sampler �� f-��r e S QC Data J<evel D (Standard) ❑ Level C 0 Level B U Level A U <br /> Turnaround Working Days ❑3 Working Days ❑2 -8 Hours ❑ Drinking Water Analyses Requested <br /> EL <br /> Time ❑ 7 Working Days U 2 Working Days ❑Waste Water <br /> ❑ 5 Working Days 0 24 Hours her <br /> Client Date/Time Matrix # of Cont Sequoia's �r� Comments <br /> Sample I D Sampled Desc Conk Type Sample # �] <br /> Pultnl- 2. X105 Z W 1W0 / ✓ ✓ <br /> 0 <br /> a <br /> 2 AAw-3 14 ✓ ✓ <br /> 3 w- o <br /> 5 --� ass <br /> 6 PiUh. WC—. x 020 <br /> 7 <br /> 0 <br /> 0- <br /> 8 Q' <br /> a� <br /> 9 <br /> 10 <br /> Relinquished By Dated Time �U Received By Date Time 33 <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Lab Date Time <br /> Were Samples Received in Good Condition? 0 Yes U No Samples on Ice? L0-Yes ❑ No Method of Shipment Page of / - <br />