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WU 003 .Jarvlb UFIVe - iviOrgari viii, 1.H "U,51 - <<+UO) 110-anw - rHR �'+uo) /04-0aua <br /> �SEQUOIA ❑ 819 Straker Ave�ite 8• Sacramento, CA 95834 • (916) 921-9600 FAX (916) 92i-0 <br /> ANALYTICAL 0 <br /> ❑ 404 N Wiget L Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 <br /> CHAIN OF CUSTODY LJ 1455 L3 1551 Indust alcDowell Road -San Carlos CA 94070 a(6 0) 232-96000 FAX (s 0) 232-9612 <br /> CA 94954 * (77) 792-1865 FAX 07) 792-0342 <br /> Company Name L)TC ,sGC► i Protect Name r �� � 5 ) 65-"0 <br /> Mailing Address 1//7 Lc"'C /1 A, At, �, ,/cBilling Address (if different) <br /> City �1,� 1 � State Zip Code <br /> Telephone 1 U y. �7, -- — FAX # 2Tf_ 579- Z Z7S PO # � <br /> rReportToT"Itl u1 4 , vtir-wi Sampler ex n re- QC Data evel D Standard 0 Level C ❑ Level B ❑ Level A U <br /> Y <br /> Turnaround l0 Working Days ❑3 Working Days D 2-8 Hours ❑ Drinking Water Analyses Requested <br /> a. <br /> Time ❑ 7 Working Days ❑2 Working Days ❑Waste Water <br /> ❑ 5 Working Days ❑24 Hours �kdther� � �� <br /> .L\ <br /> Client Date/Tune Matrix # of Cont sequoia's �w Comments <br /> Sample I D Sampled Desc Cont Type Sample # K ' <br /> 40LjJ <br /> i►ti l <br /> J � <br /> Cr <br /> 2 (1) <br /> U) <br /> 3 o <br /> } <br /> 4 <br /> 5 <br /> 6 <br /> i <br /> 7 i 0 <br /> D <br /> Cr <br /> 8 rn <br /> 9 <br /> 10 TT <br /> Relinquished By „�� Date 03 rc no Time /� Received By E.r ��f - Date �f`j- Time `� <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Lab Date ATime <br /> Were Samples Received in Good Condition? ❑Yes 0 No Samples on Ice? �es ❑ No Method of Shipment 4ri r E Page / of <br />