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UOIA ANALYTICAL U 680 Chesapeake Drive • Redwood City, CA 9406.1 • (b5U) Jb4-yJIJUU 1`-AA t03V) ,]o4-acs, <br /> 4D U 819 Striker Avee 8 • Sacramento, CA 95834 - (916) 921-9600 FAX (916) 921-0 <br /> 404 N Wiget Lan •Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-967 ` <br /> W CHAIN OF CUSTODY p 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> Company Name LL 1 fi ! Project Name O �T <br /> C� '� -� Billing Address (if different - f <br /> Mailing Address �j�eJ�a . 9 ) <br /> u B L C� _ _ 5 To 5� PR.©- EEL Cr ' D Vt� CSM I Ltd <br /> City State Zip Code c� q <br /> Telephone 5 � ��j� y FAX # PO # � ato d— W Qt <br /> U <br /> Report To u Lp �y�L Sampler �- 1� ti�o ! h QC Data Level D (Standard) ❑ Level C ❑ Level B 11 Level A <br /> Y <br /> Re <br /> Turnaround El 10 Working Days U 3 Working Days U 2 - 8 Hours U DuAnalyses Requested <br /> Water Y q a <br /> Time U 7 Working Days U 2 Working Days U Waste Water <br /> U 5 Working Days )(24 Hours `Other l v <br /> Client Dale/Time Matrix # of Cont Sequoia's Comments <br /> Sample t D Sampled Desc Cont Type Sample # <br /> 1 C©m —P 1 /2 / 5o IL 81218E V <br /> a <br /> a <br /> Q) <br /> 2 <br /> 3 0 <br /> } <br /> 4 <br /> 5 <br /> 6 <br /> rt <br /> 7 c <br /> a <br /> U <br /> 8 <br /> a <br /> S <br /> 9 t <br /> 10 <br /> Relinquished By ate 1 me Received By Date Time <br /> I <br /> Relinquished By Date Ti Received By Date Time <br /> Relinquished By <br /> Date Time Received By Lab Datej2) Time <br /> Were Samples Received in Good Condition? )<Yes U No Samples on Ice?_-Q es U No Method of Shipment Page _of <br />