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N r t 0 rt 276 4 U 885 Jarvis Drive - Morgan Hill, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 <br /> v U 819 Striker Ave , Suite 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> )404 N Wiget Lane-Walnut Creek, CA 94598- (925) 988-9600 FAX (925) 988-9673 <br /> TOSCOU 1455 McDowell Blvd 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 Project NamepJ7 lllXtA I Q <br /> Address G-147 (EgagJ TOSCO Engineer(required) E <br /> City 2)09LCP,3 State aftZip Code 69 W / 0 / 075 <br /> Telephone qO5 <br /> FAX #,'Z ,-7 SQ Site #, City, State 81 U E <br /> Report To Ebu6 Sampler r MCI �0QC Data ALevel D (standard) ❑ Level C U Level'B ❑ Level A v <br /> Turnaround X10 Work Days ❑5 Work Days 0 3 Work Days ❑Drinking Water Analyses Requested � <br /> Time ❑ 2 Work Days ❑ 1 Work Day ❑2-8 Hours %T�� � d <br /> ©Waste Water % <br /> 4 "1P \P <br /> CODE: ❑Misc Detect ❑ Eva! ❑ Reined ❑Dernol ❑Closure Other � tion , ���, 'A <br /> Client Date/Time Matrix # of Cont Sequoia's Comments <br /> Sample I D Sampled Desc Cant Type Sample # <br /> 1 W-3~P 5 G�DZ-Q r = ©A OrA -e <br /> 3 <br /> 4 0 <br /> 5 } <br /> 6 <br /> 7 <br /> 8 <br /> 9 ` <br /> 0 <br /> 10 :3 <br /> cr <br /> a� <br /> Relinquished By Ve Time Received By Date //Y/61/ TimeZ9. - I <br /> Relinquished By Dater 3 d/ Time 15-Y10 Received By Date Time �S <br /> Relinquished By Date Time Received By Date I Time <br /> Were Samples Received in Good Condition? ❑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 the report issued within the requested turnaround time? ❑7 EllNo If no, what was the turnaround time? <br /> Approved by Signature Company __ .__ Date <br />