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1i 8885 Jarvis Drive • Morgan Hill, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 <br /> UOIA ANALYTICAL Ogl u19 Striker Ave , 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-01ID � <br /> U 404 N Wiget Lane alriut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 <br /> qw CHAIN OF CUSTODY U 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> U 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Company fir P y Name—_- A lC� p,ssoc:�a�res Project Name"Ln� t _ S G 1 o n ��' / 981, 000/ <br /> Mailing Address �� L e- Yc AVS ,�e- 3 Billing Address (if different) <br /> CityState _Zip Code 9535 1— <br /> Telephone 2d Z2-Z1 _ FAx 4 201- 5?9-4ZZS Po # <br /> Report To Sampler A Iex S QC Data ,Level D (Standard) ❑ Level C ❑ Level B ❑ Level A v <br /> x <br /> Turnaround 10 Working Days U 3 Working Days U 2 8 Hours U Drinking Water Analyses Requested L <br /> Time U 7 Working Days U 2 Working Days U Waste Water <br /> U 5 Working Gays U 24 Hours )40ther 6 lll) <br /> Client Date/Time Matrix # of Cont Sequoia's , <br /> Comments <br /> Sample I D Sampled Desc Cont Type Sample # A9 <br /> 1DKA Flo rll I _ <br /> 0 <br /> Cr <br /> 3 MVJ -'3 :Lc 0 <br /> 4 <br /> 5 <br /> 6 <br /> 7 T <br /> Q <br /> 8 <br /> 9 m <br /> r <br /> 10 <br /> Relinquished By �� Date - 1-3 Time OS-,19 Received By Date 6 13 Time <br /> Relinquished By _ Date -r Time ��f Received By, DaEe > Time <br /> Relinquished By Date Time deceived By Lab Date Time <br /> i <br /> M Were S,wii,ln5 Received in Good r;onchuon? U Yes U No Samples on Ice? Aes U No Melhod of Shipment �� ► ZI'` Page t of j <br />