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�rQUOIA ANALYTICAL ❑ 680 Cesapeake nrive • Redwood City, CA 94063 • (650) 364-9600 FAX (650) 364-9" <br /> ❑ 819 Striker Ave., ( s 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-01t _ <br /> W UAIN 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:�"`G Q5 'C" _ Project Name: ,." <br /> Mailing Address: `i,7 J ,,, <br /> S�'K�1 hce, <br /> —IJY�. a �v��-Q, Billing Address (if different): <br /> City: i „S State: Zip Code: 53-5..t <br /> TelephoneZ09_579, _ZZZ FAX #: Zc�g—�r.7q,���Z� P.O. #: <br /> c <br /> Report To: .-- .m <br /> v� Sampler: f.tore QC Data: evel D (Standard) ❑ Level C ❑ Level B LJ Level A U <br /> Turnaround 10 Working Days ❑ 3 Working Days ❑2-8 Hours D Drinking Water Analyses Requested c <br /> Time: ❑ 7 Working Days ❑2 Working Days ❑Waste Water �O a <br /> ❑ 5 Working Days ❑24 Hours Mo/ 3/J' 0, ther <br /> Client Date/Time Matrix # of Cont. Sequoia's ��z j 5 O j <br /> Sample I.D. Sampled Desc. Cont. Type Sample # qp Comments <br /> S b I ✓ <br /> 2. MV11tc�}g 6y V/ ✓ <br /> 3. M� -3 <br /> roao o V <br /> 4. o <br /> 5. <br /> 6. <br /> 7. <br /> c� <br /> 8. :3 <br /> Cr <br /> U) <br /> 9. <br /> a� <br /> 10. wc <br /> Relinquished By: f Date: Time: <br /> y,�� Received By: <br /> Relinquished By: Date: 9-J_.7 7 Time: /?, . Received By: Date. <br /> Time: <br /> Relinquished By: Date: Time: Received B Lab: / I <br /> / y Date: Time: <br /> Were Samples Received in Good Condition? O Yes ❑ No Samples on Ice? I1d'Yes ❑ No Method of Shipment A <br /> P —C/)(lYi X_' Page of _r_ <br />