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_80 C t�sapea rive Me woo COfi3• fi50) 3fi4-960Q.'. 650) 36 <br /> OUOIAAN�4LYTIC�►L - - — - r <br /> �❑ 819'Striker Ave., Suite 8, Sacramento, CA 95834 �`:(91f) 921-9600:FAX (916) 921-D <br /> CHAIN KOF CUSTODY ❑_404 N.Wiget Lane:.-Walnut Creek; CA 94598• (925) 988-9600'FAX (925) 988-9673 <br /> ❑ 1455 McDowelLBlvd. North, Suite D • Petaluma,:CA 94954- (707),;792=1865..FAX (707) 79270342' <br /> Company Name: Project-Name: To ,. <br /> Ono <br /> Grq <br /> Mailing Address:�� Billing Address (if.different): z ; <br /> City: State: Zip Code;9�' <br /> Telephone:-209- 57'x• 222 f FAX #:�pq��'J►�.��ZS' . P.O. #: <br /> ..+ <br /> _ Report To: p Sampler: { QC Data: Level D {Standard) O Level C ❑ Leveoff <br /> l B ...'U Level A c� <br /> . , .-. Y <br /> Turnaround Working Days - ❑3 Working Days ❑2-8 Hours ❑Drinking Water' Analyses Requested ��- <br /> Time: ❑ .7.1Norking Days ❑2 Working Days ❑Waste Water• <br /> ❑ 5 Working Days ❑24 Hours tether a <br /> Client. ., Date/Time Matrix # of Cont.;: Sequoia's �� . Q Comments <br /> Sample I.D. Sampled Desc. Cont. Type Sample # <br /> y11�% a - <br /> _ E0 <br /> 2. <br /> 4.7. <br /> Ire <br /> TE <br /> ... A � ��� �4 � ��" [,a �� �� S � I.`n� �uI}!,`. ��4"moi��3• ��adT �w, r`. ��. <br /> Cr <br /> -' - 10. <br /> Relinquished By: Date:Qq/gyp Time: . :+� _ Received Byc ;. .: �'` . • Dater Time: / ,ir <br /> Relinquished By: Date: Time: Received By: Date: <br /> Relinquished By: Date: Time:. Received By Lab: Date: Time: <br /> Were Samples Received'in Good Condition? ❑Yes ❑ No. Samples on Ice? aesx ❑ No Method of Shipment:gj�u t+ &ff Page of <br />