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SEQUOIA ANALYTICAL ❑ 885 Jarvis Drive • Morgan Hill, CA 95037 + (408) 776-9600 + FAX (408) 782-6308 <br /> ❑ 1455 N McDowell Blvd, Suite D • Petaluma, CA 94954 • (707) 792-1865 • FAX (707) 792-0342 <br /> WAOF CHAIN OF CUSTODY CJ 819 Striker Ave , Suite 8 e Sacramento, CA 95834• (916)921-9600 • FAX (916) 921-0100 <br /> ❑ 2430 Sprig Court, Suite G • Concord, CA 94520 o (925) 356-3150 • FAX(925)356-0109 <br /> Company Name 7 j 1 Protect d. - <br /> Maihng Address ra , Billing Address (if different) <br /> City PhItIA,V State Zip Code ,o <br /> Telephone ffojj ,0 o Fax# 0 -v a PO # <br /> Report To �e, E-mail dress �jk� , QC Data Lovel II (standard) ❑ Level III ❑ Level IV <br /> Sampler A & Date/Time Results Required Sequoia's Work Order it GJ Sr <br /> Turnaround 10-15 Working Days ❑ 72 Hours MANDATORY �Q �,. ANALYSES REQUESTED Please rovide method <br /> Time (Standard TAT) ❑ 48 Hours ❑ SDWA(Drinking Water) <br /> ❑ 7 Working Days ❑ 24 Hours ❑ CWA(Waste Water) <br /> ❑ 5 Working Days © 2-8 Hours ❑ RCRA(Hazardous Waste) �L <br /> ❑ Other <br /> Client Date 1 Time Matrix #of Container Sequoia's '��v �, %0\S Comments/ <br /> Sample I D Sampled Oesc Cant Type Sample# Temp If required) <br /> ItAML, ,r <br /> 1_ 3 d q33 419 V W <br /> 2 3LI&4 t y 4"0 1 <br /> 3 - 3111f � -� tlzo <br /> M 7c + rr f <br /> 4 jg4 z � t <br /> 5 �J - P 3 3a kiL� SOS <br /> 6 IAW �,(✓ 3rf3/o !3 �i �(P <br /> -LAyj I A A& 1013 0 <br /> 8 0-3L 3114104- d LJO �Y <br /> 9 & Of 11-bo --ZA <br /> 10 L ldZ( LO 2 P7 <br /> Relinquished by 1 Co Date 1 Time 1 Temp a <br /> Relinquished by/Co Received by I Co Date 1 Time 1 Temp <br /> Relinquished by 1 Co Received by 1 Co Date 1 Time 1 Temp <br /> Relinquished by I Co Received by 1 Co Date 1 Tme 1 Temp <br /> Were Samples Received In Good Condition? XJL Yes ❑ No Samples on Ice? Yes 0 No Method of Shipment Page-Lof-2 <br /> White Sequoia Yellow Sequoia Pink Client <br />