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lcor <br /> ( 6ZUOIA ANALYTICAL iz <br /> Ll 680 C�esapeal( -'rive • Redwood City, CA 94063 • (650) 364-9600 FAX (650) 364 " ,3 <br /> El 819 Striker Ave., —,jite 8 • Sacramento, CA 95834• (916) 921-9600 FAX (916) 921- <br /> �I 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) 792-0342 <br /> Company Name' c, Project Name kn ' �� ���oh � <br /> 05 <br /> Mailing Address: IWT LOV\L `�.a1� �V�. Svc fie, Billing Address (if different): <br /> City:MO&A0 Stater Zip Code: 3S-� <br /> Telephone: _t�7 _ ZZZ FAX #:�pq_S79-Z? P.O.#: <br /> Report To:s Sampler:AVw- l-o mS QC Data: Wevel D (Standard) 0 Level C ❑ Level B ❑ Level A U <br /> Y <br /> Turnaround V10 Working Days ❑3 Working Days ❑2-8 Hours ❑ Drinking Water 7 Analyses Requested <br /> IL <br /> Time: ❑ 7 Working Days ❑2 Working Days ❑Waste Water <br /> ❑ 5 Working Days ❑24 Hours "they <br /> G w <br /> Client Date/Time Matrix # of Cont. Sequoia's <br /> Sample I.D. Sampled Desc. Cont. Type Sample # Comments <br /> 0 <br /> 2. too 4 Cr <br /> a) <br /> 3. MvJ 3 # LA ✓ o <br /> 4. <br /> 5. <br /> 6. <br /> 7. ca <br /> 0 <br /> 8. aD <br /> 07 <br /> 9. <br /> 10. <br /> Relinquished By: Date:0903?(? Time: lySd Received By`: �4�f( � Date:9.s-1 Time-/,�.jjo <br /> Relinquished By: Date: Time: Received By: Date: Time: �. <br /> Relinquished By: Date: Time: Received By Lab: Date: Time: <br /> Were Samples Received in Good Condition? ❑Yes ❑No Samples on Ice? Yes ❑ No Method of Shipment �V o ri ek Page 1 of <br />