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�- , .. . .r..vv. tiwa•� r u-.' - "" "vo) !oe_-D3ut$ <br /> i 0819 Striker Ave, Suite 8•Sacramento, CA 95834• (916) 921-9600 FAX (916) 921-0100 <br /> ❑404 N Wtget Lane •Walnut Creek, CA 94598• (925) 988-9600 FAX (925) 988-9673 <br /> TOSCO 0 1455 McDowell Blvd North, Suite D• Petaluma, CA 94954- (707) 792-1865 FAX 707) 792-0342 <br /> Il ❑ 1551 Industrial Road•San Carlos, CA 94070•(650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company J, Project Name <br /> Address11 <br /> M TOSCO Engineer(required) ED <br /> I <br /> City it rD State Zip C6de <br /> Telephone �� FAX# ��� s7� Site#,,City, State <br /> Re ort To I T <br /> P , Sampler QC Data YLevel D (standard) 0 Level C U Level B ❑ Level A <br /> Turnaround Y10 Work Days U 5 Work Days U 3 Work Days 0 Drinking Water Analyses Requested Y <br /> c <br /> Time U 2 Work Days U 1 Work Day U 2-8 Hoursp Waste Water a- <br /> JI % \ <br /> CODE: u Misc U Detect 0 Eval ❑Remed Demol ❑Closure Xther �C3.0 ° \\ <br /> U /` <br /> Client Date/Time Matrix #of Cont Sequoia's <br /> Sample I D Sampled Desc Cont Type Sample# �Q�� ��'� �� `a`�w ��`� Comments <br /> r ,, 3� o f •S <br /> tiL r tCPO< <br /> 2e �s ` 0 <br /> Cr <br /> 3 MWa7-19, ZO <br /> 4 MW <br /> 5 u1fir42, <br /> 7 8-efig <br /> —67 <br /> 9 <br /> 10 o <br /> Cr <br /> U) <br /> Relinquished By ai Date 9i�c7/ Time Received ate k p( Timei-7 -1 <br /> Relinquished By Date Time Received By Date Time <br /> i <br /> Relinquished By Date Time Received By Date Time <br /> Were Samples Received in IGood Condition? 0 Yes U No Samples on Ice? U Yes U No Method of Shipment Page J_of <br /> To be completed upon receipt of report <br /> 1)Were the analyses requested on the Chain of Custody reported EllYes 0 No If no, what analyses are still needed9 <br /> 2)Was the report issued within the requested turnaround time? 0 Yes U No If no, what was the turnaround time? <br /> Approvacd6okwu Signature iCompany <br /> p Y <br />