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Q 885 Jarvis Dnve•Morgan Hill, CA 95037 • (408) 776-9600• FAX (408) 782-6308 <br /> r- 70 819 Striker Ave , Suite 8•Sacramento, CA 95834 • (916) 921-9600 FAX 916 921-0 <br /> �� '❑ 404 N Wiget Lane•Walnut Creek, CA 94598 • (925) 988-9600 FAX 925 988-9673 <br /> 100 <br /> Tosco Suite D • Petaluma, CA 94954 • (707} 79( ) <br /> ❑ 1455 McDowell Blvd North, 2-1865 FAX (707) 792-042 <br /> O 1551 Industrial Road• San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company TY1 Project Name �� -O gx� � <br /> Address t 1 ST-_ I TOSCO Engineer (required) <br /> TO <br /> City Q� f State Zip Code +►J" <br /> Telephone v� FAX # _�� y, State E <br /> Site #, City, <br /> m <br /> Report To - Sampler QC Data Level D (standard) ❑ Level C ❑ Level 8 ❑ Level q ca <br /> Turnaround / 10 Work Days Cl 5 Work Days Q 3 Work Days ❑Drinking Water Analyses Requested <br /> Time ❑ 2 Work Days © 1 Work Day ❑2-8 Hours a. <br /> El Waste Water 1 10\ <br /> CODE: 0 Misc ©Detectl O Eval ❑Remed ❑Demol L1 Closure ❑Other �,�, a .� � <br /> Client Date/Time Matrix # of Cont Sequoia's <br /> \v�1�� �P `� � �P �\�O � <br /> Sample I D Sampled Desc Cont Type Sample # �Qk � ' Comments <br /> 1111 r �, ►r% 1(. _ S 5 <br /> �'kv-3 ! J <br /> Crco <br /> 419103 2V' <br /> �jj <br /> II 6* 1 <br /> � <br /> iFAW <br /> Gil- �II[ Y <br /> 10 1[ <br /> ID <br /> N <br /> Relinquished By &&-e <br /> Wcal Dat 9 Time Received By Date Time i <br /> r <br /> Relinquished By Date Time Received By 101 Date Time; <br /> Relinquished By Date Time Received B Dat Time per, 4 <br /> Were Samples Received in Good Condition? ❑Yes D No Samples on Ice? 0 Yes ❑Nothpd of ipment Page_of, <br /> Ta be completed upon receipt of report <br /> 4. <br /> 1)Were the analyses requested on the Chain of Custody reported? 0 Yes 0 No If no, what analyses are still needed? <br /> 2)Was the report issueh within the requested turnaround time? ID Yes ❑No If no, what was the turnaround time? al 0 'A <br /> Approved ! Signature Company - Y, <br />