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A � �A��-► 9 S Ave e 8 ram CA 4 • 921 W FA t6) 9 6 � _ <br /> O A /-1 U 404 N Wiget L�Walnuf Creek, CA 94598 • (925) 988-9600 FAX (925) 988-967310 <br /> l U 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792 1865 FAX (707) 792-0 2 <br /> v CHAIN OF CUSTODY U 1551 Industrial Road - San Carlos, CA 94070 - (650) 232-9600 FAX (650) 232-9612 <br /> Company Name D lc- 4 t�rQ3+: Q C- �*5.0 c Project Name ldef�w.J 0+ S po <br /> Mailing Address G1, C�Z%A_ �t4 Billing Address (if different) --_---- - -- <br /> City State ic.�, Zip Code tiSa'�z- <br /> Telephone �� L FAX # 34�► ,�y,� PO # <br /> ,� <br /> U <br /> Report To 'D,yr. !3 *-400,1 7Sampler -Pw- 1'!W4 `' OC Data Level D (Standard) U Level C U Level B U Level A , <br /> Turnaround pf-10 Working Days U 3 Working Days U 2-8 Hours U Drinking Water Analyses Requested a <br /> Time J 7 Working Days 0 2 Working Days 0i4maste Water <br /> i <br /> U 5 Working Days 0 24 Hours U Other71 <br /> Client Date/Time Matrix # o1 Cont Sequoia's S' Comments <br /> Sample 10 Sampled Desc Cont Type Sample # `V <br /> 0 <br /> -_ _ --- M <br /> Cr <br /> 2 3 d '' '� x X U) <br /> 3 'l o 7* XX <br /> 5 - y� x ► --OS X k Ly <br /> s S° <br /> T <br /> 3 _ps X n <br /> C 52 ----- ��v - - -- - - - - - <br /> 17 <br /> Time <br /> Heluu wished B Date /Z.�y, Time 1320 Received By Date / �{&/w _ - '---- <br /> Rulinyuished By �� Date / ,/,e Time Received By Date c� Time <br /> - -- �0 <br /> Relinquished B Date 1 5/ Time , i�j-� Received By a Time <br /> , HPLOvrd in Good Condition? U Yes U No Samples on Ice? U Yes 'J No Method of Shpne* Paan of <br /> I - <br />