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TO ChM <br /> - Redwood City, CA 9406 <br /> ftUOIA ANALYTICAL ❑ 819 St ker Ave k, to 8 Sacramento, CA 95834• (916))921-49600-9600 <br /> 2 149 6 0 00 FAX (9116) 92601 <br /> wo 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 ASS 0 G,0.N CS "C Project Name 0001 <br /> Mailing Address 111"7 �Oyv "7 Billing Address (if different) <br /> City )A0 r3 State (, Zip Code Cj 538 <br /> Telephone 7oq- 579_ 2 2 Z I FAX # Wi--rj` 4- 2225 P0 # <br /> Report To -D<evJ Ali Sampler ex �2 S QC Data "vel D (Standard) ❑ Level C ❑ Level B ❑ Level A v <br /> Ail <br /> Turnaround, 0 Working Days ❑3 Working Days ❑2 - 8 Hours ❑ Drinking Water �^ Analyses Requested <br /> CL <br /> Time (/❑ 7 Working Days ❑2 Working Days ❑Waste Water ' <br /> ❑ 5 Working Days ❑24 Hours gp vtherr VJ <br /> Client Date/Time Matrix # of Cont Sequoia's �- <br /> Sample I D Sampled Desc Cont Type Sample # Comments <br /> 1 �yV--� �W�9� f� Y� 0.5 ✓ � � � <br /> 0 <br /> Cr <br /> 2 m <br /> U) <br /> 3 0 <br /> r <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> a <br /> a) <br /> 8 0 <br /> a� <br /> 9 c <br /> 10 <br /> Relinquished By ,� ,� Date Time Received By % S r __. T`.�' Date J Time <br /> ROmqutshed By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Lab Date Time <br /> Were Samples Received in Good Condition? ❑Yes ❑ No Samples on Ice? �L Ves ❑ No Method of Shipment �!O3 OV A f f7 Page of <br />