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0 tkaIUUTA ANALY III.AL �DOV LIIC �dxe urive ' eowoaa +ry, UA y4U0J kDOU) 004-UMU rAA tno n4-yLdd <br /> HAl N OF CUSTODY ❑ 819 Stn ve , Suite a Sacramento, CA 95834 (91(916) 921-9600 FAX 1-0100 , <br /> ❑ 404 N Wiget Lane • Walnut Creek, CA 94598 • (510) 988-9600 FAX (510) 988-9673 <br /> Company Name TRMI EH&S Project Name 70 f LOCI _—y I <br /> Address Texaco Loc.# 625640276, 440 W. Charter Way Billing Address (if different) 108 Cutting Boulevard <br /> City Stockton State CA Zip Code Richmond, California 94804 <br /> Telephone (510)236-3541 FAX # (510)237-7821 PO # <br /> Report To Deidre Kerwin (BTS) Sampler �� sy,i, QC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A U <br /> Turnaround U10 Working Days 0 3 Working Days ❑ 2 - 8 Hours ❑ Drinking Water . Analyses Requested � <br /> Time ❑ 7 Working Days ❑ 2 Working Days ll J ❑Waste Water <br /> Cl 5 Working Days ❑ 24 Hours i i ❑Other y V, <br /> Client Date/Time Matrix # of Cont Sequoia's \ � � 4Q �� � � <br /> Comments <br /> Sample I D Sampled Desc Cont Type Sample # q��� � <br /> (,J iloQ T <br /> 2 A / lost � 3 ''� ��. � 0° <br /> 1133Z "W ; �c 63 <br /> s , <br /> 13yb Vo4 <br /> /lowl �J , 3 vopr <br /> ,. <br /> 71 s I�IU.I-�1 't�� �ly y W 3 <br /> 9 LMW -t0 � A 3 <br /> 10 <br /> Relinquished By ate 101,1457101 Time /D 2 j Received B Date ` Time ,IZ� <br /> Relinquished 8y ,q Datel///y Time Received By Date Time <br /> Relinquished By Date Time Received By Lab �} Date Time <br /> N Samples Received in Good Condition? ❑Yes ANT Samples on Ice? *es O No Method of Shipment F-5 Page of <br />