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oUU ,J ❑ 819 Striker Av uite 8 •Sacramento, CA 95884 • (9 161 ue i-vuuu i n„ �a,u) <br /> U 404 N Wiget W•Walnut Creek, CA 94598• (925) 988-9600 FAX (925) 988-96 <br /> TOSCO0 1455 McDowel Ivd North, Suite D • Petaluma, CA 94954• (707) 792-1865 FAX 792-0342 <br /> _ U 1551 Industrial Road •San Carlos, CA 94070 •(650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company �t R c�ri .=he - Project Name J <br /> ftd�y.�.v.z y G��.��r G��b 13LV I,')- <br /> Address f q 5,, ,}� �` TOSCO Engineer (required} 1,1--V„ d C „rttIr� <br /> City �, State G/i Zip Code 9,yr w Q <br /> Telephone gS Sf' SSSS! FAX # �,� -� Sf_ �� Site #, City, State I Ick C <br /> Report To � �G Sampler . QC Data AlLevel D (standard) © Level C ❑ Level B Ll Level A U <br /> x <br /> Turnaround10 Work Days 0 5 Work Days - 0 3 Work Days EJ Drinking Water Analyses Requested <br /> o_ <br /> Time 2 Work Clays U 1 Work Day ❑2-8 Hours ❑Waste Water ,� �P%IV, 3 <br /> CODE: U Misc ❑Detect 0 Eval ❑Remed ©Demol ❑Closure Nther <br /> Client Date/Time Matrix # of Cant Sequoia's <br /> Sample I D Sampled Desc Cont Type Sample # Comments <br /> 6 nx y <br /> 1 AA W- 3 •Prc <br /> l T <br /> J W3: 0 <br /> 2 a <br /> a� <br /> 3 <br /> 3 <br /> 4 c <br /> 5 <br /> 6 <br /> 7 <br /> 8 i <br /> I <br /> i0 <br /> Relinquished 8y Date i 3 Q.. Time Received By Date / 710( Time <br /> Relinquished By l - Date e.i TimeReceived By Date &01 Time <br /> Relinquished By - Date Time - Received By Date Time <br /> a <br /> Were Samples Received in Good Condition? ❑Yes O No Samples on Ice? 0 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 />