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El 1455 McDowell Blvd, Suite D„• Petaluma, CA 94954 • (707)792-1865 • FAX (707) 792-0342 <br /> SEQUOIA ANALYTICAL Ll 819 Striker Ave , Suite 8 + Sacramento, CA 95834 • (916) 921-9600 + FAX (916) 921-0100 <br /> ❑ 1551 industrial Road + San Carlos, CA 94070 • (650)232-9600 • FAX (650) 232-9612 <br /> CHAIN OF CUSTODY ❑ 404 N Wiget Lane • Walnut Creek, CA 94598 + (925) 988-9600 • FAX (925) 988-9673 <br /> 11911 Protect 6oZ-�Jo�sv-oH <br /> Company Name -s ++�� BiIVmg Address (if different) <br /> Mailing Address l tl.15 N 3 1��+. <br /> City � State Zip Code $s-asPO # adz -7ati �f <br /> Telephone UL ?7 Q7 t31 Fax# (_6vzL,-7 s-o� I eve <br /> E-mail Address ),(o r a,�. �s r. ecw► QC Data D Level 11 (standard) © Le <br /> Report To S-�� 1,�f j.,,� Sequoia's Work Order# �U <br /> Sampler Date 1 Time Results Required <br /> El 72 Hours MANDATORY ANALYSES RE UESTE Please rovide me <br /> Turnaround 10-15 Working Days El 48 Hours ElSDWA(Drinking water) <br /> Time (Standard TAT) <br /> C17 Working Days ❑ 24 Hours ❑ CWA(Waste Water) �4 <br /> ❑ 5 Working Days ❑ 2-8 Hours ❑ RA(Hazardous Waste) V <br /> p�Qther , , ,t 4,x- �� <br /> S 111,1'1 Via; ,q` j A, g <br /> • r . r ti `: <br /> IM 4' Comments/ <br /> Client Date 1 Time Matnx #of Container! ;�Sequoia's 'X�, i Temp If required <br /> Sample I D Sam led Desc Cont T Sam Ie # s t <br /> IL <br /> z � '� <br /> t7:oD 3 / <br /> 2 v 5' <br /> J 1-7 <br /> ' p3Y 14 n�A kb rS <br /> 4 W'�� ;n1l1 <br /> 1}rf1�' t1 <br /> 5 1 `�_ / 1 a,q� �7.1 <br /> 17,zv <br /> 6 JAW- L15 <br /> �3 s#.,mob <br /> 8 4th Cf «6rVTxF� bY'� r <br /> Ik I <br /> AY010 M <br /> 10 to „�`, -�,,.. „ .mss w ���, ��, <br /> �"R�Ce�iied By>k,��P Y �- Date 1 Tlme <br /> Relinquished By - �� Date 1 Time <br /> Relinquished By Receive By <br /> Received By Date 1 Time <br /> Relinquished By Received By Date!Time <br /> Relinquished By Page-j—of 3 <br /> ; Were Samples Received in Good Condition? es 0 No samples on Ice? yes ElNo Method of Shipment <br /> White Sequoia Y Sequoia <br /> Pink Client <br />