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U 680 Chesapeake Drive • Redwood City, CA 94063 • (650) 364-9[�UU I-AA (b5U) 364-9233 <br /> SEQUOIA ANALYTICAL <br /> U 819 Striker Ave., Suite 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> CHAIN OF CUSTODY X404 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-l�T'�' 1— Rtj 10C , Project Name: TO S � ` 5— L 0� RIO <br /> Mailing Address: rp� S e1 .C►, C' % S �(' Billing Address (if different): r �, (� <br /> City: P q 13 IL 'll, N State: C Zip Code: �,S- $ TO� CO P PLO 3-IL" CTM����Y�-1� i �R-V F CAM00 XD � <br /> Telephone: �� l�S —FAX #: S S; �" I CoP.O. #: 1� �0 S —tJ 9902025 _m <br /> U <br /> Report To: Y O urj-- LIS� Sampler: 1& � QC Data: Aevel D {Standard} O Level C ❑ Level B ❑ Level A , <br /> Y <br /> Anal ses Re � <br /> Turnaround ❑ 10 Working Days ❑ 3 Working Days U 2 - 8 Hours U Drinking Water Y Requested Q <br /> Time: ❑ 7 Working Days U 2 Working Days U Waste Water <br /> Cl 5 Working Days X4 Hours 40ther X,�rir�]„�/ <br /> Client Date/Time Matrix # of Cont. Sequoia's Comments <br /> Sample I.D. Sampled Desc. Cont. Type Sample # <br /> 111—$T t �, I Vo A s 02015 V" �/ 0 <br /> _a <br /> 2. co <br /> 3 <br /> 0 <br /> 3. } <br /> 4. <br /> 5. <br /> 6. <br /> c� <br /> 0 <br /> 7. :3 <br /> Cr <br /> V <br /> U) <br /> 8. m <br /> 9. L� <br /> 10. <br /> 11799 Time: <br /> Relinquished By: Date: Time: t7 r7P Received By: Date: 0 <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> Relinquished By: Date: Time: Received By Lab: Date: Time: <br /> Pad. ,. of <br /> Were Sampt,,s Received in Good Condition? >Yes U No Samples on (es U No Method of Shipment — <br />