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OQUOIA ANALYTICAL © 680 Chesapeakve • Redwood City, CA 94063• (650) 364-9600 FAX (650) 364 <br /> 11819 Striker Ave , alta 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0V <br /> 4W 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 -11 P G 2N Protect Name <br /> Mailing Address 33� g I�irse32L/ IZ� Billing Address (if different) <br /> City CState C ,g Zip Code 9-56$� <br /> Telephone S3U FAX # 5 -h PO # <br /> Report To Sampler QC Data 691-evel D (Standard) ❑ Level C ❑ Level 8 © Level A v <br /> x <br /> Turnaround ❑ 10 Working Days ❑3 Working Days ❑2 - 8 Hours ❑ Drinking Water Analyses Requested <br /> ii <br /> i <br /> Time ❑ 7 Working Days ❑2 Working Days ❑Waste Water <br /> 5 Working Days ❑24 Hours 'Other <br /> Client Date/Time Matrix # of Cont Sequoia's ��� Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> 1 Mf r v- Z 7 , sy w V X3, v� 111r-vl <br /> 0 <br /> 2 s w �- 1 , s 3 v - (V Cr <br /> 3 r 3 <br /> 0 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 0 <br /> Cr <br /> $ °) <br /> a� <br /> 9 r <br /> 10 <br /> Relinquished By Date _/ Time Received By Date Time <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By La Date Time <br /> Were Samples Received in Good Condition? U Yes U No Samples on Ice? U Yes ❑No Me Shipment__ ____ __ Page _ of <br />