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w Li� Ja�riveIle: <br /> rga , C�37 4W) 7AWO 0 4W (4G"2-6� 1 <br /> UOIA ANALYTICAL ❑ 1455 McDowelluite D • Petaluma, CA 94954 • (707) 792-1865 + FAX (707) 342 <br /> 819 Striker Ave , 8 • Sacramento, CA 95834+ (916) 921-9600 • FAX (916)92 - 00 <br /> 1WCHAIN OF CUSTODY ❑ 1551 Industrial Road + San Carlos, CA 94070 • (650) 232-9600 • FAX (650) 232-9612 <br /> ❑ 404 N Wiget Lane • Walnut Creek, CA 94598 • (925) 988-9600 + FAX (925) 988-9673 <br /> Company Name PZ Q,"(K /� Project lz S <br /> Mailing Address ZC4, <br /> 4V6,/ Billing Address if different) <br /> City - State (A. Zip Code .9FS-2, .L' <br /> Telephone ?.r)-7 3 q_o L __F_� { PO # <br /> Report Toate,, (jie�1,�� E-mail Address QC Data Level II (standard) ❑ Level III D Level N <br /> Sampler Date 1 Time Results Required Sequoia's Work Order# <br /> Turnaround X 10-15 Working Days ❑ 72 Hours MANDATORY ANALYSES REQUESTED Please Drovide method <br /> Time (Standard TAT) ❑ 48 Hours ❑ SDWA(Drinking Water) <br /> ❑ 7 Working Days ❑ 24 HoursCWA(Waste Water) t <br /> ❑ 5 Working Days L32-8 Hours 91 RCRA(Hazer <br /> ❑ Other <br /> 4 <br /> Client Date 1 Time Matrix #of Conjal � y' ia s Comments! <br /> Sample I D Sampled Desc Cont Sample# Temp(If required) <br /> 1 �W- ��� �� 0 37 0 ' '4' bia X <br /> 2 V04CV"re- �x <br /> -Z- <br /> I,/ <br /> �� <br /> 4 G-I9 I,/ W P3 vs <br /> 5 i��' 6t) e, x � �; "I . <br /> 6 ;lOiz <br /> p <br /> 7 `� <br /> d s x '"t,� �. 'eWT <br /> TNAS <br /> Re <br /> T3 <br /> u `APt; fi L <br /> 10 <br /> Relinquished By A Date /Time 6-15-6-2 J Z o <br /> Relinquished By Receive Date/Time 1�9 <br /> Relinquished By Received By V Date I Time <br /> Relinquished By Received By Date 1 Time <br /> Were Samples Received in Good Condition? ❑ Yes Ll No Samples on lce? ❑ Yes ❑ No Method of Shipment Page Z of—_ <br /> White Sequoia Yellow Sequoia Pink Client <br />