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t M M M mom Mao M M lm men <br /> i <br /> YTICAL" �680 Chesapeake Drive• Redwood CAy, CA 94063 • {415) 364-9600 FAX(415)364-9233 <br /> SEQUOIA ANAL <br /> ❑ 819 West Striker Ave • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> CHAIN OF CUSTODY ❑ 1900 Bates Ave-, Suite LM• Concord, CA 94520 •(510) 686-9600 FAX (510) 686-9689 <br /> Company Name d 1,11 „ f <br /> Project Name nb 7 <br /> Address DJ E Q.1 j)G , y Cp Billing Address { rf different) <br /> City f`UA State G4 Zip Code <br /> Tele hones FAX#g P O # a_ <br /> U <br /> Re rt To Sam ler QC Data Level A(standard) ❑ Level B ❑ Level C ❑ Level D <br /> x <br /> Turnaround iA,10 Working Days ❑ 3 Working Days ❑ 2 -8 ours ❑ Drinking Water JAnaiyses Re uested a <br /> Time: ❑ 7 Working Days ❑ 2 Working Days - ❑ Waste Water <br /> ❑ 5 Working Days ❑ 24 Hours ❑ Other <br /> Client Date/Time Matrix #of Cont Sequoia's Qi <br /> Sample I D Sampled Desc Cant Type Sample# Comments <br /> 1 3 ((019!; � � D1 0 <br /> 0 <br /> Cr <br /> 2 tlO o0 x p o <br /> 4 UJ (6 Ck 10 <br /> Of <br /> 6b <br /> 7 0 <br /> 0 <br /> Cr <br /> 8 c�i <br /> a� <br /> 9 c <br /> 10 <br /> RelinquishedI36( A Date 31 1�1 915 Time '4p Received By - Date Time <br /> 'Relinquished By D Time Received By Date Time <br /> r )7_' 46 <br /> • Reli uished B Date Time Received B Lab? ate sine <br /> y Were Samples Received in Good Condition?kYes❑No Samples on Ice ;dyes 0 No Method of Shipment Page I of J_ <br />