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U 819 Striker Arne, c e 6- Sacramento.CA 95834.(916)921-9600 FAX (916) 921-0100– n <br /> • 404 N Wiget Lai 491nut Creek, CA 94598 •(925)988-960(] FAX (925) 988.9673 • cci <br /> TSC ❑ 1455 McDowell Blvd North, Suite D- Petaluma,CA 94954- (707) 792-1865 FAX (707) 792 0342 <br /> U 1551 Indtusinal Road-San Cados,CA 94070- (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company r Project Name , , +, , r '/k <br /> Address TOSCO Engineer(required) <br /> City State Zip Code ,, WIMI 60 <br /> r <br /> Telephone - FAX # Site#,City, State <br /> - F � <br /> Report To I,, I Sampler r 4 QC Data btevel D(sian&rd) O Level C O Level B O level A v z <br /> Umara and b,10 Work Days ❑5 Work Days ❑ 3 Work Days R Drinking Water Analyses Requested c <br /> n- <br /> 7lrne' ❑ 2 Work Days a 1Work Day U 2 8 Hours U Waste Water ` s <br /> CODE: O Wsc Detect 0 Evel ❑Remed ❑Demol ❑Closure 401hor , 1ti �\�`� m <br /> At <br /> Client Date/Time Matrix # of Cont Sequoia's v�� v���� Comments <br /> z <br /> Sample I D Sampled Desc Cont Type Sample 0 �Q� ��� �� �'�` Jo`' <br /> 3 -- <br /> 4 i <br /> 5 _ _ <br /> r <br /> 6 <br /> 7 U <br /> n <br /> u <br /> B T u <br /> _ a <br /> a <br /> 9 0 'a <br /> 110 Cr <br /> nr c <br /> 0 <br /> Relinquished By Date ', Time (I'" Received By ! , t date �' K' <br /> Relimpished By Date Time Recenr+ed By Date Time <br /> Relinquished By Date Time Recenred By Date Time c <br /> r <br /> Were Samples Received in Good Condtlon? U Yes U No Samples on icer U Yes U No Method of Shipment _ Page_ of _ <br /> r <br /> r <br /> To be mnpleted upon receipt of report <br /> 1)Were the analyses requested on the Cham of Custody reported? Dyes 0 No It no,what analyses are stili needed? <br /> 2)Was the report issued within the requested turnaround time? 0 Yes 0 No If no what was the turnaround time? �— <br />