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❑ 885 Jarvis Drive - Morgan Hill, CA 95037• (408) 776-9600• FAX (408) 782-6308 <br /> SEQUOIA ANALYTICAL ❑819 Striker Ave , Suite 8 • Sacramento, CA 95834 -(916) 921-9600 FAX (916) 921-0100 <br /> L1404 N Wiget Lane -Walnut Creek, CA 94598- (925) 988-9600 FAX (925) 988-9673 <br /> VW- CHAIN OF CUSTODY ❑ 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954• (707) 792-1865 FAX (707) 792-0342 <br /> ❑ 1551 Industrial Road - San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Company Name d Protect Name 1 4 L <br /> MailingAddress <br /> 3 / [�S% - % Billing Address (if different) <br /> City V, f I-e, S �,, s State Zip Codee/,5Z— <br /> Telephone _7-17, t Zo FAX # S�7, PO # 21 D0 <br /> Report To (`; W�� ,- Samplers QC Data ; Level D (Standard) ❑ Level C ❑ Level B ❑ Level A v <br /> Turnaround &10 Working Days D 3 Working Days ❑2-8 Hours ❑ Drinking Water Analyses Requested <br /> EL <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 DescCont Type Sample # ro rip Comments <br /> 1 �L -/-7,5 <br /> 0 <br /> 2LI�J-� -30 �( X Cr <br /> cn <br /> A O <br /> It � 1`;�6 -05 <br /> � 3 <br /> `��^f �`i if--?• Y'�S'Cinsn)'�.y � ��i ^rzV.,� 'S y,� ?:}6 � (am <br /> ` R <br /> zm <br /> GreEa�t � �ss~Lca <br /> { <br /> A d <br /> 0 <br /> U) <br /> 1U �Il✓,44- Z- "bJ JL� <br /> 3 <br /> Relinquished By w-, —� Date -/ -01 Time 1n: 30 Received B "114b( Time"-- <br /> Relinquished By Date Time Received By IDate Time <br /> Relinquished By Date Time Received By Date Time <br /> Were Sam s Received in Good Condition? ❑Yes ❑ No Samples on lce ❑Yes ❑No Method of Shipment Page_of_ <br />