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V `�yUL" iu 819 Striker Ave uite 8 • Sacramento, CA 95834 • (916) 921-960 FAX (916) 921- <br /> ©404 N Wiget L •Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-967 <br /> -- Tosco ❑ 1455 McDowell tsivd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 _ <br /> ❑ 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company ora�io� project Name <br /> YA C!Ae Zor <br /> Address 39.3 �'c�n,br7 z24o TOSCO Engineer (required) <br /> Cp p /sem <br /> Cityclall, State Zip Code 9S�kZ <br /> Telephone �G7�_6f2 FAK #r <br /> 2,,,r—6-g,pS Site #, City, State <br /> Report To k S Sampler d.— QC Data ,�Level D (standard) ❑ Level C U Level B ❑ Level A v <br /> Turnaround )0 10 Work flays ©5 Work Days ©3 Work Days ❑ Drinking Water Analyses Requested <br /> e <br /> Time ❑ 2 Work pays ❑ 1 Work Day ❑2-8 Hours ❑Waste Wafer <br /> CODE. U Mise U Detect LlEval ❑ Remed 0 Demol ElClosure 1d Oth6s lz C o, oa°`� C,�eP oc�P <br /> Client Date/Time Matrix # of Cont Sequoia's <br /> Sample I D Sampled Desc Cont Type Sample # 1Q�� ��� ��� �Q�` ~�� `��� � Comments <br /> s",iQ S�IalS� ,� L" p-o <br /> ro <br /> 0 <br /> C&",trt s,—e IX,1 Cr <br /> (D <br /> I 3 � <br /> 4 o <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> ro <br /> 10 <br /> Cr <br /> a� <br /> m <br /> Relinquished 8y Dat � <br /> e �/oa Time Received By Date Time v <br /> Relinquishe y Date Time Received By Date Time <br /> f <br /> Relinquished By Date Time Received B��� �Date/ (� Time <br /> Were Samples Received in Good Condition? D 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 />