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819 Striker Ave , Suite 8 Sacramento, CA 95834 916 921-9600 FAX 916 921-0100 <br /> ' ( } ( } <br /> U 404 N Wiget -Walnut Creek, CA 94598 - (925) 988-9600 FAX (925) 988-967 <br /> Osco U 1455 McDoweTlMd North, Suite D - Petaluma, CA 94954 - (707) 792-1865 FAX ( 792-0342 <br /> U 1551 Industrial Road - San Carlos, CA 94070 (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company �� 60 d Protect Name �'� ,w Z <br /> Address 1-IM CAMf,�! � TOSCO Engineer (required) <br /> City Ptr/- State Zip Code Kkrg Z <br /> Telephone FAX # S3o ��G-� Site #, City, Statesco / C <br /> Report ToMA'k C.�pPS Samplers J.7� ; OC Data �I_evet D (Standard) Ll Level C U Level B U Level A U <br /> x <br /> Turnaround r�10 Work Days L7 5 Work Days ❑3 Work Days G Drinking Water Analyses Requested a <br /> Time U 2 Work Days 0 1 Work Day ❑2-8 Hours ❑Waste Water °1 p <br /> CODE: U Misc U Detect 0 Eval 0 Remed U Dermol ❑ Closure Pn9ther�,o. Al °ti°, ago\ 1h�oa �AN`°5 <br /> Client Date/Time Matrix # of Cont Sequoia's <br /> Sample I D Sampled Desc Cont Type Sample # 1Q�\ 0��� ���� �Q�� �,a�� ��� ,�<1� Comments <br /> _2h, 4e W: E(go"o Cr <br /> 3 1`1 w- 12-6-) <br /> 3 <br /> 5 M 41 (S' <br /> fi Mw0 9 a sI e <br /> 7 rrt w f (zo') <br /> 8 w S'� oy+r3 �i <br /> 7-OLA r <br /> 9 p L- <br /> 1 �t�;o �! <br /> 0 <br /> 10 _D 1 Leda � <br /> U) <br /> Relinquished By Date 21b'/qo Time y3 Received By Date Time c <br /> Relinquis d By Date Time Received By Date Time <br /> Relinquished By Date Time Received By - Date �� Time <br /> Were Samples Received in Good Condition? Cl Yes ❑ No Samples on Ice? ©Yes © No Method of Shipment Page of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes ❑ No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes ❑ No If no, what was the turnaround time? <br /> Approved by Signature _ Company ___ Date <br />