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a <br /> r <br /> i.�A <br /> UO1 A ❑ 680 Chesake Drive • Redwood Cit , CA 94063 • 415 364� j A� Y t ) 9600 FAX (415) .i64-9233 <br /> L� 0. 819-West Striker.Ave. • Sacramento, CA..95834 •-(916)-92-1•-9600-FAX (9i 6)-921=0100I YOf UqDy- ❑ 1900 Sates Ave., Suite LM • Concord, CA 94520 • (510) 686-9600 FAX (510) 686-96E <br /> Company Name: �' r Project Name: <br /> n p Gni <br /> Address: r,d!tea 3 Billing Address ( if different): <br /> City: ,j" State: Zip Code: <br /> Tele hone: FAX#:&VSSG- 5-.2,77 P.o. #:= . <br /> Report To. ��i• Sam ler: r--- v <br /> �r�) QC Data: ❑ Level A(standard) ❑ Level B ❑ Level C ❑ Level D <br /> Turnaround ❑ O Working Days ❑ 3 Working Days ❑ 2 -8 Hours ❑ Drinking Water Anal sed Re uested <br /> Tlme: ❑ 7 Working Days 2 Working Days o <br /> ❑ Waste Water <br /> ❑ 5 Working Days ❑ 24 Hours ❑ Other �O <br /> 3 <br /> Client Date/Time Matrix ##of Cont. Sequoia's <br /> Sample I.D. Sampled Desc. Cont. Type Sample # Comments <br /> JL. �� 5I17#y WaA y x <br /> m <br /> 2. <br /> 7 <br /> 3. Iyer/3 " , .. �, �' <br /> .� a <br /> 4. r <br /> 5. <br /> 6. <br /> 7. <br /> r 9, Af <br /> data cn <br /> m <br /> 10. 1> <br /> Relinquished S <br /> q Y ate�Ifl <br /> Time: f�,3d Received Date: ime: <br /> Relinquished 8 Tim t Received B — -- <br /> Y Date: Time:----- <br /> Relinquished <br /> ---- <br /> Relin uished S . Date, me-� Received By Lab: Dale ime: + 1� <br /> Were Samples Received in Goad Condition?❑ Yes 0 No Samples on Ice? Q Yes ❑ No Method of Shipment Page _of <br />