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e6680 Chesap a Drive• Redwood City, CA 94063 • (650) 364-9600 FAX (650) 3&33 <br /> b 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 /> �/ CHAIN OF CUSTODY <br /> ❑ 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954• (707) 792-1865 FAX (707) 792-0342 <br /> Company Name AR, Assoc►a Project Name /64rec, P� � O <br /> Mailing Address 1117 La Fqlpo tJ Billing Address (if different) <br /> City 1140cle510� State Zip Code 95351 <br /> Telephone 201— 577- ZZZ I FAX # -ZA - $7 , 'ZZ-ZS- PO # <br /> Report To hh4L. Sampler A" r QC Data V6evel D (Standard) ❑ Level C ❑ Level B ❑ Level A v <br /> Turnaround &Z Working Days ❑ Working Days El2- 8 Hours C3Drinking Water Analyses Requested <br /> Time ❑ 7 Working Days ❑2 Working Days ❑Waste Water <br /> ❑ 5 Working Days ❑ 24 Hours <br /> Client Date/Time Matrix # of Cont Sequoia's �� tl`� <br /> � Comments <br /> Sample I D Sampled Desc Cant Type Sample # <br /> 1 M - yqa r3w Vr °i <br /> 0 ✓ <br /> 0 <br /> Cr <br /> 2 MW" <br /> Z 1325 0z ✓ ✓ ✓ <br /> 3 M� •'J 133 s <br /> ✓ ✓ ✓ a <br /> 4 Mw� y�L )3qS � � ✓ ✓ ✓ } <br /> 5 taw- 5 135 S d 5 ✓ ✓ ✓ <br /> 6 to I q0le ✓ <br /> 7 0 <br /> Cr <br /> 0 <br /> $ U) <br /> 9 <br /> 10 <br /> Relinquished By Ate y, .v Date a3aSq g Time )Lf Z4 Received By ` Date 3 Time ft(Z <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Lab -:Fr:ot r— Date y9 Time /,766 <br /> y,vkrK <br /> Were Samples Received in Good Condition? L3Yes L)No Samples on Ice? VS-*Yes 0 No Method of Shipment e&Lk -r— Page / of 1 <br />