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..,...... <br /> 16819 Stryker Ave , Suite 8• Sacramento, CA 95834• (916) 921-9600 FAX (916) 921-0100 <br /> El 404 N Wiget Lanalnut Creek, CA 94598• (925) 988-9600 FAX (925) 988-9673 #2-0342 <br /> STOSCO © 1455 McDowell BI Orth, Suite D• Petaluma, CA 94954•(707) 792-1865 FAX (707) <br /> 0 1551 Industrial Road •San Carlos, CA 94070•(650) 232-9600 FAX (650) 232-9612 - <br /> Consultant Company Project Name � � Ota <br /> Address L�JTOSCO Engineer(required) <br /> City State Zp Code <br /> Telephone Co 00 FAX # �(� 9 7l :Sit:e #, City, State O� �- <br /> Report To Sampler AL O QC Data vel D (Standard) ❑ Level C U Level B U Level A <br /> Turnaround0 Work Days ❑5 Work Days F❑3 Work Days ❑ Dunking Water Analyses Requested S <br /> Time ❑ 2 Work Days 0 1 Work Day ❑2.8 Flours IL <br /> ©Waste Water \ 1 P��, % <br /> CODE: U Mise ❑Detect ©Eval ©Remed O Demol ❑Closure jOther � o� <br /> �P ,moo <br /> h , <br /> Client Date/Time Matrix # of Cont Sequoia's �P�, `PP oa�� <br /> Sample I D Sampled Desc Cont Type Sample# ,tQ`Z'� 0�`�� ����` �Q�� J��b�` ���`� Q Comments <br /> Uri <br /> t W I�Ga � q ��o ti r � XB�• <br /> 2 Z� <br /> Cr <br /> 4 �� r <br /> a <br /> 5 — <br /> Ab <br /> 7MW(0 -- <br /> 8 !log <br /> C,a <br /> �Vi <br /> 10 MW 44 DL <br /> �V � <br /> Cr <br /> ell I <br /> Relinquished B � <br /> 9 y Date (p or Time/5W— Received B ate l+7 Time <br /> Relinquished By Date <br /> Resin Time Received By Date Time <br /> Relinquished B <br /> q y Date Time Received By Date Time <br /> Were samples Reoemed in Good Condition? Q Yes ©No Samples on ice? ©Yes 0 No Method of Shipment <br /> Page of <br /> To be completed upon receipt of report <br /> 1)Were the analyses requested on the Chain of Custody reported? ❑Yes 0 No If no, what analyses are still needed? <br /> 2)Was the report issued within the requested turnaround time? 0 Yes I]No If no, what was the turnaround time? <br /> Approved by Signature <br /> Company Date <br />