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ICUOIA ANALYTICAL ❑ 680 Ches a Dave• Redwood C�#y, CA 94063 • (415) 364-9600 FAX (414-9233 ' <br /> ❑ 819 West Striker Ave • 5 cr men <br /> CHAIN O F CUSTODY a a to, CA 95834 • (916) 921-9800 FAX (916) 921-0100 ; <br /> WAV <br /> ❑ 1900 Bates Ave , Suite LM • Concord, CA 94520 • (510) 686-9600 FAX (510) 686-9689". <br /> Company Name �, t Project _f <br /> r�. 1� ^ <br /> '(J-S&a c i. Name <br /> Address Billing Address ( d ddferent) <br /> City L }n;/s State f' Zip Code <br /> Telephone // � '� FAX# 4 ����-�:`% J`� P D # m <br /> Re 22 rt To A r,�-, Ls�miler ,L p,2 -- QC Data Z11 Level A(standard) ❑ Level B ❑ Level C ❑ Level D <br /> Turnaround 1:3 10 WorkingDas s c <br /> Y ❑ 3 Working Days ❑ 2 -8 Hours ❑ Drinking Water Analyses Re uested (L <br /> Time ,b 7 Working Days ❑ 2 Working Days ❑ Waste Water <br /> p ❑ 5 Working Days ❑ 24 Hours ❑ Other <br /> Client Date/Time- Matrix #of Cont Sequoia's J �` <br /> Sample I D Sampled Desi Cont Type Sample# '�� Comments <br /> 2 lye,A) <br /> to <br /> 5 � r <br /> 6 # I <br /> 7 ` <br /> 0 <br /> $ 3 <br /> Cr <br /> m <br /> 9 ' <br /> Relinquished B � -���t�-_-- i �� , <br /> q Y ,� �/ Date %j Time , � Received By Date y/ /G <br /> Relin Time �S <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Mme Received By Lab 1 Date 1Time <br /> Were Samples Received to Good Conddion?,d"Yes❑N\ Samples on Ice? &Y--es U No Method of Shipment Page of_ <br />