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S-N661-INT06, 0 885.Jarvis Drive a Morgan Hill, CA 95037 - (408) 776-9600- FAX (408) 782-6308 <br /> 2 19 Striker Ave , Suite 8 e Sacramento, CA 95834 - 916 921-9600 FA921-0 <br /> �I '0 404 N Wi et Lane•Walnut Creels, CA 94598• { ) FAX (9 16) -9673 00 <br /> S <br /> �O g (925) 988-9600 FAX (925) 988-9673 <br /> 0 1455 McDowell Blvd North, Suite D - Petaluma, CA 94954 - (707) 792-1865 FAX (707) 792-0342 <br /> 0 1551 industrial Road- San Carlos, CA 94070 a (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company '[ _ ) <br /> ,� ry Project Name 9 � /,r <br /> Address � TOSCO Engineer (required) [/ \ <br /> City State �- Zip Code <br /> Telephone FAX # d Site #, City, State <br /> 11 _m <br /> Report To 11441ex Sampler ©C Data 4evel D (Standard) 0 Level C 0 Level B 0 Level A U <br /> Turnaround 10 Work Days O 5 Work Days O 3 Work Das O Drinkin Water <br /> y 9 Analyses Requested G <br /> Time 2 Work Days © 1 Work Day O 2-8 Hours a. <br /> O Waste Water <br /> CODE: O Misc ❑Detect 0 Eval 0 Remed 0 Demol to Closure O Other , <br /> Client Date/Time Matrix # of Cont Sequoia's <br /> Sample i D Sampled Desc Cont Type Sample # �Q`Z`' ���L �ti��' 1Q�� o�U� �`�� Comments <br /> r,,. ! " �,�; <br /> 1 11V" 1 J ! I �L/ I t2;Is-1"— <br /> 2 'v a 1� t v � o <br /> Cr <br /> 4 <br /> 5 G�' <br /> _ f-43 ` 1 <br /> 7 0 r3s <br /> Al 2 j 13t� r3i. <br /> 9 )'7 t4 <br /> 10 0 <br /> Cr <br /> Relinquished By ate J�j TimeB7 Received By Date Time <br /> Relinquished By Date Time Received By <br /> RelinquishedDate ane 3 <br /> B <br /> Y Date Time Received B Date d />� Time <br /> Were Samples Received In Good Condition? O Yes ONO Samples on Ice? ❑Yes O No thod of S ment Page of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes O No If no, what analyses are stili needed? <br /> 2)Was the report issued within the requested turnaround time'? ❑Yes O No If no, what was the turnaround time? , <br /> Approve Signature _ Company <br /> 11 & -- - � � <br />