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❑885 Jarvis Drive#;T <br /> Hill, CA 95037- (408) 776-9600• FAX (408) 782-6308 i <br /> Ne- 008246 U819 Striker Ave Sacramento, CA 95834• (916) 921-9600 - FAX91 s 921-0100 <br /> FAX(916) <br /> msco 1]404 N Wiget Lame- Walnut Creek, CA 94598• (925) 988-9600•FAX (925) 988-9873 <br /> 01455[McDowell Blvd, North, Suite D- Petaluma, CA 94954- (707) 792-1866 - FAX(707) 792-0342 <br /> U 1551 Industrial Road -San Carlos,CA 940/70- (650) 232-9608- FAX (650) 232-612 <br /> Consultant Company C O`,. Tosco Engineer, fir/ <br /> Address I IlC[L r7( site# 9 <br /> City IZ+9nc 4,a. �, tate, C+ Zip Code 49 rG 7 C> Site Address Itio'l C vw <br /> C <br /> Telephone (� _ tD Fax# J-- 0430 City, State <br /> Report To ,,yf* Samplery f QC Data yrLevel D (Standard) Ll C Q Level 8 ❑Level A U <br /> Y <br /> C <br /> Turnaround 1K10 Worts Days ❑ 5 Work Days ❑ 3 Work Days ❑ Vnnking Water Analyses Requested is. <br /> Tlme ❑ 2 Work Days Q 1 Work Day Q 2.8 Flours ❑ Waste Water <br /> ❑ Other A L N <br /> Project Coding <br /> Client Dat <br /> Sample LD Sampled Descx Cont Type Sample# �Q� � o�� o �" Comments <br /> 1. 1 1t+►r 2- -v i h zD V0 <br /> 2 f �°j PA k1 1 L4 3 <br /> 3 Ez`3n hzv 0 <br /> Cr <br /> ss A14 i <br /> 6 •� ��~�rel Z, A- <br /> 7 <br /> 8 <br /> 9 g <br /> 10 �l• N <br /> Relinquished G�� Date Z Tim - Received B ate �2 Tme V& <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time. Reserved a, Date 1 Time, <br /> Were Samples Received in CoW Conditbn? L.I 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 an the Chain at Custody reporled9 ❑Yes I]No It no,what analyses are still needed? <br /> 2)Was the report issued wdhin the requested turnaround time-7 Q Yes Q No if no,what was tha turnaround time? <br /> Approved by Signature Company Date <br />