Laserfiche WebLink
` �OUOIA ANALYTICAL P1680 Ches2;�`V :e Drive • Redwood City, CA 94063 • (650) 364-9600 FAX <br /> ❑ 819 Striker Ave., Suite 8 • Sacramento, CA 95834. 916 921-9600 FAX 916 921-0100 <br /> ii CHAIN OF CUSTODY ❑ 404 N.Wiget Lane • Walnut Creek, CA 94598 • (510) 988-9600 FAX (510) 988-9673 <br /> Company Name:A-rC GS Project Name:qkva 11W odd 1 <br /> Address: /2(, Y4 ; r Billing Address (if different): <br /> City: /W oa/z,5State: Zip Code:p53 S j <br /> Telephone: 2Oc?- 5 7g- ZZZ l FAX#: ?69-57 17- ZZZ5 P.O. #: <br /> LD <br /> Report To: Sampler: rC�S U <br /> p �ov„� p � � QC Data: evel D (Standard) ❑ Level C L e <br /> Turnaround 10 Working Days ❑3 Working Days ❑2 - 8 Hours ❑ Drinking Water Analyses Req J%D�Lb <br /> 4 <br /> Time: ❑ 7 Working Days ❑2 Working Days ❑Waste Water <br /> ❑ 5 Working Days ❑24 Hours *Qther <br /> Client Date/Time Matrix # of Cont. Sequoia's 4O�� � Comments <br /> Sample I.D. Sampled Desc. Cont. Type Sample # <br /> 1. W- X20 b625�r8 <br /> 3 �OtaSg � d ✓ ` �r���-�Stlr1 <br /> CLS 'O <br /> 2. M vi-2 ►2251( 2s�� 3 ✓ ,/ Q.s p Pb o r C <br /> 3. M w -3 i2t5 ab25 � J ✓ ✓ �,e�se. Prov1d� <br /> 9 Go P i o 0 <br /> Gkroxna•�b9nxwnS <br /> 4. <br /> S VA OL S <br /> 5. <br /> 6. <br /> }} r <br /> 0 <br /> 8. °' <br /> 07 <br /> a� <br /> 9. <br /> r <br /> 10. <br /> Relinquished By: ,QJ0_ Dater Time:/�/S Received By: �>�G`' Date: Time:/l2./, r_ <br /> i <br /> Relinquished By: Date: ;Z� Time:/��/ Received By: ate: ime: / <br /> Relinquished By: Received By Lab: Date: ��/ Time: U LIS <br /> -Were Samples Received in Good Condition? 0 Yes ❑ No Samples on Ice? 6X65 0 No Method of Shipment MM 6que(e Page of <br />