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Lk 680 Chesapeake Drive • Redwood City, CA 94063 • (415) 364-9600 U 18939 120th Ave., N.E., Suite 101 • Bothell, WA 98011 • (206),481-9200 <br />V <br />U 819 Striker Ave., Suite 8 • Sacramento, CA 95834 • (916) 921-9600 U East 11115 Montgomery, Suite B • Spokane, WA 99206 • (509) 924-9200 <br />U 1900 Bates Ave., Suite LM • Concord, CA 94520 • (510) 686-9600, U 15055 S.W. Sequoia Pkwy, Suite 110 • Portland, OR 97222 • (503) 624-9800 <br />Company Na- / <br />- <br />Name: <br />Address: <br />- •- <br />r <br />Zip Code: <br />Release #: <br />Telephone.State: <br />I <br />,. .- <br />Data: <br />• �••••�•�-•-••w •-r +v vvvtn vdys tJ 0 vvorK nays 1J 5 worK bays ❑ Drinking Water <br />Time: ❑ 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours ❑ Waste Water <br />CODE: ❑ Misc. I Detect. L)Eval. LlRemed. ❑ Demol. ❑ Closure ❑ Other <br />Client Date/Time Matrix # of Cont. Laboratory <br />Sample I.D. Sampled Desc. Cont. Type Sample # <br />2. n - �I <br />3. <br />IMMMMON <br />4.A <br />5. b <br />6. <br />7. <br />8. SP -Z <br />9. <br />10. <br />Relinquished By: <br />- . - • !K <br />AMMMot MWORM <br />�Vlff ITiime: i 7/0 I Received Bv: <br />ME• <br />immmmmm <br />Relinquished By: I Date: Time: I Received B 1-46 t (Ci 14aate:: ��a'71VfTime: <br />Were Samples Received in Good Condition? (Yes D No Samples on Ice? Yes U No thod of Shipment tl ll j't9 f (6111/ffte� Page cgof 222- <br />To be completed upon receipt of report: <br />1) Were the analyses requested on the Chain of Custody reported? D Yes 0 No If no, what analyses are still needed? - <br />2) Was the report issued within the requested turnaround time? U Yes LJ No If no, what was the turnaround time? - <br />flrlrlr�VPf'l hN' C�^natllr�• (�mm�arn' <br />