Laserfiche WebLink
. '� U U1J;10 ❑819 Striker Avrte 8•Sacramento, CA 95834• (916) 921-9600 FAX (916) 921- <br /> X104 N Wiget L •Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-967 <br /> 0 <br /> TOSCO ❑ 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 Z�fS-oZ Project Name3 O UI <br /> U77,(f . ,- '�u i V TOSCO Engineer(required) <br /> D&Yft OW7r1l <br /> City r State _ Zip Code' �"' <br /> Telephone 5 �'/ r ss S FAX # rj' r -- �/' Site #, City, StateE <br /> Report Toa Sampler [' QC Data evel D (Standard) ❑ Level C El Level B ❑ Level A v <br /> Turnaround 1 10 Work Days ❑5 Work Days ❑3 Work Days ❑Drinking Water Analyses Requested L <br /> Time �` 2 Work Days Eli Work Day ❑2-8 Hours UWaste Water 9\ �& eti`�, r <br /> 51 <br /> CODE. ❑Misc Q Detect ❑ Eval ❑ Remed ❑ Demo] ❑ClosureOther <br /> �°` <br /> Client Date/Time Matrix # of ContSequoia's� Qph`� �`�° <br /> Sample I D Sampled Desc Cont Type Sample# �Q'Z` ��`�� ��� �Q�` �1°�a�\ ���`° Comments <br /> - 4ZU J- bA u <br /> 121 3, 05-4D - X a <br /> Cr <br /> 3 <br /> 4 <br /> 0 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> co <br /> 10 � <br /> Cr <br /> m <br /> Relinquished By Date Time Received By Date / Time r;,3t� <br /> Relinquished By f l/�% Dater <br /> Time/,r Received By DatedM V 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 stili needed? <br /> 2)Was the report issued within the requested turnaround time? ❑Yes ❑ No if no, what was the turnaround time? <br /> Approve Signature Company <br />