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Q ANALYTICAL ❑ 684 ChesWUOIAe Drive • Redwood City, CA 94063 • (415) 364-9600 FAX(41IB4-9233 <br /> 4D ❑ 819 Wester Ave • Sacramento, CA 95834 • (916) 921-9600 FAX (916 1-0100= <br /> PHAIN O F CUSTODY ❑ 1900 Bates Ave , Suite LM • Concord, CA 94520 • (510) 686-9600 FAX (510) 686-9689 <br /> Company Name (����T n q9! .✓% Project Name <br /> Address 3 76-c Billing Address ( it different) <br /> City Cor, State Zip Code e�,>'ES Z <br /> Telephone 7 7 - 3 �� �^ FAX# P 4 # <br /> U <br /> Re rt To C %��� / ���ie y iSampler C L!;' QC Data ❑ Level A(Standard) ❑ Level B ❑ Level C ❑ Level D <br /> Y <br /> Turnaround 10 Working Days ❑ 3 Working Days ❑ 2 - 8 Hours ❑ Drinking Water JAnaiyses Re uested <br /> Time ❑ 7 Working Days ❑ 2 Working Days ❑ Waste Water F <br /> 1:15 Working Days ❑ 24 Hours ❑ Other h1i • <br /> Client Date/Time Matrix #of Cont Sequoia's <br /> Sample I D Sampled Desc Cant Type Sample# l>> Comments <br /> jz <br /> 6 <br /> CD <br /> 2 � <br /> {� _ _ 3 1 <br /> 4 <br /> E <br /> 5 <br /> 6 <br /> 7 0 <br /> Cr <br /> 8 <br /> ' E <br /> 9 <br /> 3 <br /> 10 <br /> Relinquished By : Date Tirne)F Received Received By 1 Date Time <br /> Relinquished By Date Time Received By Date Time ; <br /> Relinquished By Date Time Received By Lab �C� �� Date-'5/3/q5 Eime T <br /> Were Samples Received in Good Condition? ❑ Yes❑ No Samples on Ice? ❑ Yes Q No Method of Shipment Page_of <br /> i <br /> E <br />