Laserfiche WebLink
i <br /> 002764 <br /> ���,{b J 000 Jdtvib UIIves Moiydll l-Iill, UA 9bU ( 1 <br /> .J1 • 4Uts /`U-JUJU • t-AA 4ub 1tic-oaVo <br /> . U 819 Striker Avite 8 • Sacramento, CA 95834 (916) 921-9600 FAX (916) 9214 <br /> ,(404 N Wiget L •Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-96 <br /> TOSCO 1:11455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> U 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company G Ccr -. R Gn Th�, jyp24 S�o S Protect Name t 5r 3 Cdfon Stub /3 L V 0, <br /> Address (� y} s i,�r►ra cJ TOSCO Engineer (required) d f�n I s n <br /> City l�u b lir State C,4 Zip Code o2yS-6 8 W/198j 9 <br /> Telephone Cal-ZS) nn- 7s-r r- FAX # �9z5 551 -T88$ Site #, City, State t/ i q <br /> U <br /> Report To ,u L� Sampler � f QC Data XLevel D (standard) ❑ Level C U Level B U Level A , <br /> x <br /> Anal Requested c <br /> Turnaround y 10 Work Days U 5 Work Days U 3 Work Days U Drinking Water Analyses q <br /> Time 13 2 Work Days U 1 Work Day ❑2-8 Hours U Waste Water <br /> L <br /> CODE' U Misc KDetect U Eval U Remed U Demol U Closure Other moa boa �y <br /> Client Date/Time Matrix # of Cont Sequoia's eP���h � Gk\ <br /> Sample l D Sampled Desc Cont Type Sample # .1o�a�` �` /� Comments <br /> CSM P 1 (A c�� SI tolo� Sor I l3r�ss O 1 f;—A <` <br /> 0 <br /> 2 a <br /> in <br /> 3 3 <br /> a <br /> 4 } <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 0 <br /> 10 6 <br /> m <br /> rn <br /> Relinquished By _ Date /o m Time Received By Date /S Time 15:zj� W <br /> t <br /> Relinquished By ��l- / Date�,i3-��/ Time / 3D Received By__JDate s% ,3r Time <br /> Relinquished By Date Time Received By Date Time <br /> Were Samples Received in Good Condition? U Yes ❑ No Samples on ice? U Yes U 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? U Yes U No If no, what was the turnaround time? <br /> Approved by __-- Signature ��__-- Company Dale <br /> -- - - ------ - - -- - q - y -------_ -------_ _— <br />