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i U t12' 3 7 U 885 Jarvis Drive• Morgan Hill, CA 95037• (408) 776-9600• FAX (408) 782-6308 <br /> V Cl 819 Striker Ave , Suite 8•Sacramento, CA 95834 o (916) 921-9600 FAX (916) 921-0100 <br /> TOSCO0 404 N Wiget Lane-Walnut Creek, CA 94598- (925) 988-9600 FAX (925) 988-9673 <br /> ❑ 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 f yew4 - b;L Project Name yo Cot►h Aprx C4--v b (3L0 D. <br /> AddressTerra C Sure TOSCO Engineer(required) l <br /> City v ;h State CA - Zip Code g qr6$ 0 0 Ll <br /> Telephone q.V-5'S1_ 7L5ss' FAX # Site #, City, State 1111.3- 2 <br /> Report To [IVAL Sampler s„„�� oC Data [.t-evel D {Standard) 0 Level C 0 level B ❑ Level A v <br /> Turnaround V,10 Work Days ©5 Work Days ❑3 Work Days ❑Drinking Water Analyses Requested !i <br /> Time ❑ 2 Work Days C31 Work Day 0 2-8 Hours C3 Waste Water \ 1 QP�4` <br /> CODE: 0 Misc ❑Detect ❑ Fval U Remed 0 Demol U Closure -AOther 1� , ` 1y ° c` � ya <br /> Client Date/Time Matrix # of Cont Sequoia's �`� �Q� ��� eP� a�\�o� p{� Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> 1 mw-3—Pet tZ-19-,0o N.-A-0 5 VOA --01 A-L X x �( 6 Axys 13 <br /> 0 <br /> 2 $],b4 Cr <br /> 3 Cn <br /> 4 0 <br /> 5 k } <br /> 6 <br /> 7 <br /> 8 <br /> 9 ' c� <br /> 0 <br /> 10 Cr <br /> m <br /> Relinquished By Date 12,1Q, Time pip Received ByZ�xzxrlrl&L4 _ Date / / Time <br /> Relinquished By � Date -164 Time /M9 Received By ` ' Date j Time <br /> Relinquished By Date Time Received By Date Time <br /> Were Samples Received in Good Condition? ❑Yes 0 No Samples on Ice? 0 Yes 0 No Method of Shipment Page—of_To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Y D No if no, what analyses are still needed' <br /> 2)W*e report issued within the requested turnaround time? ❑Ye#No If no, what was the turnaround time? <br /> Approved by I I Sionaturp r mmnonw �,_._ <br />