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U 885 Jarvis Drive • Uwan Hill, CA 95037 • (408) 776-9600 • FAX (408) 782 6308 <br /> SlUOIA ANALYTICAL >1419 Striker Ave , S • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-010t� <br /> U 404 N Wiget Lane •SIF <br /> Creek, CA 94598 • (925) 988-96100 FAX (925) 988-9673 <br /> qW <br /> CHAIN OF CUSTODY U 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> U 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Company Name Project Name <br /> SSefY to e91 �C "Uli llf ._ € -S' 10 Z5 ,Z LnooJ <br /> Mailing Address f ( `] L o nk_ a,vi,t .:L, s Billing Address (if different) <br /> City State CA- Zip Code 1535 ) <br /> Telephone c FAX # C c` PO # c <br /> S61 '+r �- `2L 2 1 �- 5319-ZZL5 <br /> Report To `-fLq P-- Sampler QC Data U <br /> P �� �.{- =a � � _��Qr�� (�Lavel D {Standard) ❑ Level C Ld Level B ❑ Level A , <br /> Y <br /> Turnaround �K,10 Working Days O 3 Working Clays U 2 -8 Hours U Drinking Water Analyses Requested <br /> a_ <br /> Time U 7 Working Days U 2 Working flays ❑Waste Water <br /> U 5 Working Days U 24 Hours ). Other <br /> Client Date/Time Matrix # of Cant Sequoia's <br /> Sample l D Sampled Desc Cont Type Sample # Comments <br /> U11300 Lg �•� res 561 S 71 ) a7 <br /> 2 til t,.! 3 ��p 'a yJ at eco �. Cr <br /> ID <br /> 3 M vJ 41 t l �,� Vr�a's �•d <br /> 3 + � o <br /> 4 Mvo, v,10 i �0 9Un ✓ } <br />� 5 <br /> 6 <br /> 7 .4 <br /> O <br /> t3 � <br /> 9 — - --- - _ <br /> 10 <br /> Relinquished 13y w �} Date [) � Time3'2-1'�J Received By Date 7 / Time(2-r— <br /> Helinquished By f bate c Time Received By MCM.41 Date _j/ILI Time <br /> Relinquished By Date Time Received By Lab `J Date Time <br /> lTVai� S ,i„��I�� ti< <+ivecl tri C,c17,f ( nnu,lion 1 <br /> IAYOU No Samples on icO Yes A No Method of Shipment C�l�� Z)�, Parte / of <br />