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UOIA A S �/MIALM <br /> Stn ec4�'r Cveu, 8 •�'acramenfo CA 9�• (9 a21- FA ) 9LiU 404 N Wiget Lan alnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 <br /> CHAIN OF CUSTODY U 1455 U 1551 IndDustrial Road ell Blvd NSan,Carlos, CA 94070 Petaluma,(650) 232 960007) 792-1865 FAX (650) 232-9612 <br /> 7) 792-0342 <br /> Company Name Project Name Azov, <br /> Mailing Addressmay Bilking Address (if different) CA <br /> S` N <br /> City C.a o i State Ca zip Code qS—Z- <br /> Telephone Z�9 369 a FAX # _ 69 QYY� PO # <br /> Report To �'4'" �"��' Sample QC Data Level D (Standard) 0 Level C ❑ Level B U revel A v <br /> r`D � <br /> Turnaround -,410 Working Days U 3 Working Days U 2-8 Hours U Drinking Water Analyses Requested c <br /> Time U 7 Working Days 0 2 Working Days !Waste Water a V 4e <br /> U 5 Working Days U 24 Hours 0 Other � <br /> aq <br /> Client Date/Time Matrix # of Cont Sequoia's /17�Q Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> 1 m <br /> a� <br /> 3 { %A Z <br /> 4 _ <br /> (� i nC. <br /> 5 - - <br /> 6 Cna olew 40Q <br /> 7 A 0 <br /> 8 23`� <br /> 9 <br /> 10 <br /> Relinquished By Date ���. Time /.�� Received By Date `� + •I Time J53S <br /> Relinquished By Date Time Received By le { Time <br /> Relinquished By Date Time Received By Date Time <br /> Were Simples Received in Good Condition) U Yes U No Samples on lcP? U Yes U No Method of Shipment Page of <br /> i <br />