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VMA MAMCRE ❑ " Ch ' k e• MRood�CA -" 34-90 f"41 -9231W <br /> 819 Wes iKer Ave - Sacramento, CA 95834 • 916 921-96 - 00 <br /> HAI N OF CUSTODY ❑ 1900 Bates Ave . Suite LM -Concord, CA 94520 - (51 0) 686-9600 FAX (510) 686-9689 <br /> Company Name v PC, RA0i �',e � Project Name <br /> Address ��� ] Z 7b- S 7 Billing Address ( d different) <br /> City '4� rry F,y�- State C�4 Zip Code 25 x-/e <br /> Tele hone 41V 3-3.P/I1 FAX# 5'1rs P O # <br /> _m <br /> ReportTo it C h it vr,,. <br /> ISampler C /7i--478"z- QC Data ❑ Level A(standard) ❑ Level B ❑ Level C ❑ Level D U <br /> Y I <br /> Turnaround 10 Working Days ❑ 3 Working Days ❑ 2 -8 Hours ❑ Drinking Water lAnalyses Re uested <br /> a <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 <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> F- <br /> 1 <br /> a <br /> 2 o <br /> 3 c <br /> 4 } <br /> 5 <br /> 6 <br /> 7 <br /> V <br /> o <br /> 8 Cr <br /> 07 <br /> 9 <br /> 10 <br /> Relinquished By Date / ��Time 2 Y Received By ,.s.,.�-r Date Time J <br /> Relinquished By Date 612456 Time 9, � Received By Date 6 z Q Time Q�'�O <br /> Relinquished B Date 1 Ti SO Received B L �t Date ime 7 <br /> Were Samples Re ed in Good Condition? Yes O No Samples on Ice7�Yes t7 No Method of Shipment .S'P(;4<61,1 Page Lof-I <br />