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VJAIN <br /> u bbU(,hesap ke Drive• Redwood Gity, CA 94063 •(415) 364-9600 FAX (415)'364-9233 <br /> UO) UOIA ANALYTICAL ❑ 819 Ste , Suite 8• Sacramento, CA 95834• (916) 921-9600 FAX (9161-0100 <br /> WO of CUSTODY ❑ 404 N Wiget Lane • Walnut Creek, CA 94598 • (510) 988-9600 FAX (510) 988-967° _ <br /> Company Name 4 ` Project Name Moort Pe f-tvPvw\ <br /> Address ~]9L)Z{ /yM,- y syr Billing Address(if different) <br /> City Air C45 - State CA Zip Code q5,6 <br /> Telephone 'V(o 135- azop FAX# ,r35-OZ0 PO # EAQc)z E0 <br /> ,Repo To -Te`r,t Pom2ery Sam ler F fag{ QC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A v <br /> �`� <br /> �c <br /> Turnaround B 10 Working Day ❑ 3 Working Days ❑ 2 -8 Hours ❑ Drinking Water JAnalyses.Requested Ia <br /> Time ❑ 7 Working Days ❑ 2 Working Days ❑ Waste Water <br /> ❑ 5 Working Days ❑ 24 Hours ❑ Other 1 <br /> Client Date/Time Matrix #of Cont Sequoia's <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> 400 4 <br /> 14•�� LJ Ao - O i x Piclore s <br /> Cr <br /> 2 ) <br /> 3 <br /> 3 ° <br /> m <br /> 4 <br /> 5 <br /> 6 <br /> 7 1° <br /> 0 <br /> Cr <br /> 8 <br /> 9 <br /> 10 <br /> Relinquished By Date ]Time,g• 30 Received By Date Time <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished B Date Time Received B Lab:5nb S� Date q ime 00 <br /> Were Samples Received in Good Condition?Q Yes Q No Samples on Ice? El Yes❑ No Method of Shipment Page—of— <br />