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1r ' I <br /> Wu6iA ANAL ICAC V-,Z80 L,u,,apej Drivel- nedwotu kity, 4H U40631• (t)60) 14-&6001t-AA (6A) 3bN 33 <br /> 4L ❑ 819 Striker Ave., Suite 8• Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> 1W 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) 792-0,'3,42 <br /> Company Name: J/ Pro ect Name: f S + <br /> 'u— i�sSc:c.\41--z3 �v�L. •-�'�Gc3..�-S�U V("Mailing Address: <br /> Q�-..,-e. Billing Address (if different): <br /> City: tl%c�&.,zsVo State: « Zip Code: q��5 <br /> Telephone: FAX #: Z-c,q•S7q , Z22-S7 P.O. #: m <br /> [Report To: J.«.,�,,��, t� .,c�y Sampler"" QC Data: VLevel D (Standard) ❑ Level C Cl_L-evet-B eve v <br /> Y <br /> Turnaround X 10 Working Days ❑3 Working Days ❑2-8 Hours ❑ Drinking Water Analyses Req ed -7-7-�, <br /> Time: 0 7 Working Days ❑2 Working Days ❑Waste Water A� <br /> r ` <br /> ❑ 5 Working Days ❑24 Hours AOther <br /> r <br /> Client Date/Time Matrix # ofCont. Sequoia's � � Comments <br /> Sample I.D. Sampled Desc. Cont. Type Sample # .C' (� /L <br /> 1. uS-gg 3-3c-o ►� �3 9'S Sc i T�bY- k X �( - - <br /> f�l <br /> 115'S�'t'ZS•O k,:.t2 .1 2 X X m <br /> 2. <br /> 07 <br /> 0 <br /> X IL Q lvsA. <br /> 5. NS-S$3' w 3�S Sxkc ,I u h X X <br /> 6. <br /> 7. <br /> 0 <br /> Cr <br /> 8. <br /> 9. <br /> 10. � <br /> Relinquished By: ate:-1,%-i-9is- Time:c1`11- Received Sys Date: ? /y-f Time: `has <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> Relinquished By: -, i c c 3/ <br /> (,4,e1s Date:�iy tJg Time: Received By Lab: Date: /tile Time: <br /> v <br /> Were Samples Received in Good Condition? 0 Yes 0 No Samples on Ice? ,(Yes ElNo Method of Shipment Co-V ', Page—L of <br />