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3 <br /> I <br /> Nil 01010 885 Jams Drive•Morgan NII I,GA 950037•(409)776 9M•FAX(406) 782-6306 <br /> 10818 Stnker Ave, Suite 8*Sacramento,CA 95$54 ■(SIG)921-9600•FAX(916)9210100 <br /> []404 N Wrget Lane•Walnut Creek,CA 94598■(925)988-9 •FAX(925)HU-01573 <br /> ❑1455 McDaw811 Blvd Forth,Suite D• Petaluma,CA 84954• (707)792-1865+FAX(707)792.0342 <br /> TOSCO ❑1551 Industrial toad■San Carlos, CA 94070•{650}232 9640• FAX 1650)232.9612 <br /> Consultant Company Le " 4 Two Fngtneer /� <br /> Address I 6 - d�- G pi7rl/ 3 r tr .. She# "{ <br /> City (d State ZIP Code- 31te Address j (0 a l 1?t vq, <br /> Telephc�ntr Q 7 _f fax# [�V' 6rrlad 14 f Clty,State + 1l v Ir � l c <br /> r pO Data Level l] ( tandard) ❑Leval C ❑Level S (_]Level A ' <br /> Report To r �1` t Sampler �0 P r <br /> , , <br /> 7urnaroUod 10 Work Days ❑5 Work Days ❑3 Work Days []1}nntcmg Water Rrlalyses Requested <br /> CL <br /> Time, [l 2 Mark Days ❑1 Work Day ❑2-6 Hours Other WasteWaters � �q� <br /> Protcct Coding z� <br /> Glfent t7atelirme Matfrx #t of Cool Sequoia's -� � '� Comments <br /> Sample I D Sampiocl Dose Cont Type samplao Z 74 <br /> 2 5 _ Vo A14_ <br /> 3 - o <br /> u <br /> 4 <br /> .5 <br /> 6 _ - <br /> 7 - <br /> 8 <br /> - _ o <br /> 10 - <br /> Relinquished t3y Date Tuna- Recelved A _ Date Time _ <br /> Relrnqulshed By Gate _ Time i ov Recaluad B <br /> ra <br /> Date 7�me <br /> Pelsn ulshed By Date Y Time Received By Qate Time <br /> wero Samples Heoeived in Good Condition [ yes La K0 Samples on Ice? FlYes ❑No Method of Shipment Page of <br /> To be comptefed upon mcotpl of teporl <br /> 1)were the anatyses requested on the Chain of Custody reported? &Yes L]No If no,what analyses are still nuodadg <br /> 2)Was the report issued within tho mquested turnaround time') V'Yes [)No It no,what was t turnaround([me?—_ -- <br /> Appr4W Darin VO 5 S li r Signature —:� �� Company �1` Date <br />