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UOIA ANALYTICAL ❑ 680 ChesaDrive• Redwood City, CA 94063• (415) 364-9600 FAX (415) 233 <br /> Ll 819 Striker Me' , Suite 8• Sacramento, CA 95834 . 916 921-9600 FAX 916 21-0100 <br /> a_ _� <br /> CHAIN OF CUSTODY ❑ 404 N Wiget Lane •Walnut Creek, CA 94598 • (510) 988-9600 FAX (510) 988-9673 <br /> _ I <br /> Company Name L �' L4 r/tt L Project Name <br /> Address �� � 4 t; t� Billing Address(if different) <br /> City State (, Zip Code <br /> Telephone `<'T ` ] F L-C-. FAX# S .� PO # <br /> Report To �, • - --- Fsampler ` l �� � ��t QC Data -5/-2evel D (standard) ❑ Level C ❑ Level B ❑ Level A V <br /> Turnaround 73 10 Working Days ❑ 3 Working Days ❑ 2 - 8 Hours ❑ Dnnking Water [Analyses Requested <br /> ii <br /> Time ❑ 7 Working Days ❑ 2 Working Days ❑ Waste Water <br /> ❑ 5 Working Days ❑ 24 Hours ❑ Other <br /> Client Date/Time Matrix # of Cont Sequoia's <br /> i <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> K� c� �� j SblU0to3 M <br /> Cr <br /> 2 <br /> 3 ° <br /> Z <br /> 4 <br /> 5 <br /> 6 <br /> 7 0 <br /> 0 <br /> Cr <br /> 8 N <br /> 9 <br /> r <br /> 10 <br /> Relinquished By tc yvDate tc, i t cls Time Received By Date Time <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Lab�f 6LL Dateia �� Lime 3 ' ) <br /> Were Samples Received in Good Condition2❑Yes 0 No Samples on Ice? ❑Yes 0 No Method of Shipment Page I of ti <br />