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/ rN _, ■�u / i /. lj '� MVV V[��v��i v� {+ V yC+l� ����, VIS NVYV/ I—V-1 , ,V ---- .'moi♦ 1—VVI •v— vvvV <br /> V 11+ ❑819 Striker Ave , e 8•Sacramento, CA 95834• (916) 921-9600 FAX (916) 921-0M <br /> 2 404 N Wiget La afnut Creek, CA 94598• (925) 988-9600 FAX (925) 988-9673 <br /> TOSCO ❑ 1455 McDowell Blvd North, Suite D•Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> lJ 1551 Industrial Road•San Carlos, CA 94070• (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company -412nc. Project Name 1yo3 e&4,1r G I u b BLVD 1 yp2 If Jr.,a2 <br /> Address 6 jL`t?�, Si crrv,. :5V'J" T TOSCO Engineer(required) r j l c <br /> City �u�,� h State G,4 Zip Code 94rdg <br /> I t+ <br /> Telephone g zS� 5s1.. VSs ' FAX# <br /> Sri X88 g Site#, City, State f s9 s-rook�oart C.4 _ <br /> Report To Lc- Sampler A :5,(A OC Data '►Level D (standard) ❑ Level C ❑ Level B ❑ Level A v <br /> Y <br /> Turnaround 6A 10 Work Days ❑5 Work Days ❑3 Work Days ❑Drinking Water Analyses Requested a <br /> Time: L112 Work Days ❑ 1 Work Day ❑2-8 Hours C3 Waste Water , � .�G <br /> CODE: ❑Misc ❑Detect ❑Eval ❑ Remed ❑Demol ❑Closure OLOther <br /> Client DateMme Matrix #of Cont Sequoia's � `� ��� a � �vo�� v-r ` Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> eill art�..•fv <br /> !Z <br /> 1 hw-3_ f 1-404 lho S VOAs x X IrTCX -Poe eu c <br /> 2 �'} x Cri <br /> Soo AL PL � c <br /> 3C/) <br /> w p ' <br /> 4 w x <br /> 5 tie f sbo�,ac x <br /> -Aft CIO a <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> s <br /> 110 <br /> Cr <br /> Relinquished By Date dig& Time 1 730 Received By Date /W/ 10 Time <br /> Relinquished By • Date Time /3.3a Received By Date Time <br /> Relinquished By Date Time Received By Date 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)Was the po issued in a requested turnaround time? ❑ s n , what was the turn ound time? S <br /> Approved by Signature Company � Date P°/ <br />