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,-j uoo ,laivi5 Uiive • ivioigan Hai, t,A 9bUJI • (4U8) //6-9bUU • FAX (408) 782-6308 46sco U U t 1).,) ❑ 819 Striker Ave , 8 a Sacramento, CA 95834 a (916) 921-9600 FAX (916) 921-01()U 404 N Wiget Lan alnut Creek, CA 94598 a (925) 988-9600 FAX (925) 988-9673 U 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 U 1551 Industrial Road a San Carlos, CA 94070 a (650) 232-9600 FAX (650) 232-9612 Consultant Company // Project Name 9 1 ell Address &17� TOSCO Engineer (required) City Z,i y i',J State C Zip Codee% l�i��,� Y j Telephone c L S 7S-'S- FAX # �Z 5 { �- ` e #, City, State �, / �f/ E LD Report To i -ccqv Sampler c— c QC Data Level D Standard LlLevel C LlLevel B ❑ Level A U Y Turnaround 10 Work Days ❑5 Work Days O 3 Work Days ElDrinking Water Analyses Requested Time 2 Work Days Ll 1 Work Day ❑2-8 Flours 11Waste Water '� a 0ti& �'` S1 S CODE: ❑Misc ❑ Detect ❑ Eval emed ❑Demol ❑Closure Other ��,�� , ��, a Client Date/Time Matrix # of Cont Sequoia's �QPgP �QP$ti �QP9� Sample I D Sampled Desc Cont Type Sample # `Q�` 0~�� X10 �Q�\ J�a�`� ��e�cComments rd m 3 O/ 4 /7 'e > 2 5 r 6 7 8 9 ca 10 Cr Q) rn Relinquished By St� ` Date 1. 1/6, Time/;-(7u Received By Date ime CD r Relinquished By Bette I 1mL!S Heceivea Date Time tzlz,l� r s ; z� Relinquished By Date ime Received By yy.G Date Time Were Samples Received in Good Condition? ❑Yes ❑No Samples on Ice? ❑Yes ❑ No Method of Shipment Page 1 ofr To be completed upon receipt of report 1) Were the analyses requested on the Chain of Custody reported? ❑Yes ❑ No If no, what analyses are still needed?_ 2) Was the report issued within the requested turnaround time? ❑Yes ❑ No If no, what was the turnaround time? Approved by Signature Company _ _ _ _ W Dale