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Li 88t)Jarvis u ive • "'But yul i , <br /> N 0- 002514 LI819 Striker Ave , Suite a• Sacramento, CA 95834 • (916) 921-9600 FAX (91b) VZ i-u iUu <br /> X404 N Wiget Lame•Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 _ <br /> TOSCO U 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 RVAV ,v e Protect Name D QU � u j8 <br /> Address �� < TOSCO Engineer (required) LZ <br /> City `J>V f?.>L„1 N State if Zip Code 0 <br /> Telephone FAX # SYr_ 7gg$ Site #r City, State - <br /> 1WINWLevel <br /> Report To SP-P Sampler �[{� QC Data ,��evel D tSiandard} ❑ Level C ❑ B © Level A V <br /> Turnaround Vito Work Days ❑5 Work Days ❑3 Work Days- ❑Drinking Water - Analyses Requested l r a <br /> Tfine ❑ 2 Work Days ❑ 1 Work Day ❑2-8 Hours p Waste Water <br /> CODE: ❑Mise ❑ Detect ❑Eval ❑Rem4d ❑Demol ©Closure }KOther 4,x <br /> Client Date/Time Matrix # of Cant _ Sequoia's _ aP� �?� ���" �eP� `��� Comments <br /> Sample I D Sampled Desc Cont Type _ Sample_# <br /> -111/10 <br /> 3M 16-x 11A 0 3 -r <br /> 4 <br /> 7 _ <br /> M <br /> 10 <br /> a <br /> - - v <br /> Relinquished By Date Time - Received By _ _ Date^///j m Time �� 9 <br /> Relinquished By i Date !! Time /,Zr{f7 Received By - Date UAqkr, Time = I <br /> Relinquished By Date Time Received By _ - _ _ Date <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) ere the analyses requested on the Chain of Custody reported? es ❑ No If no, what analyses are still needed? <br /> T T� 2=s the report issued within the requested tur around time? No li ,w��t w the turnaround time?61 <br /> - <br /> *, �J�1f,1 r1 alt -Sic�P -M 0 /1 Signature 'Comany - - to <br />