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i <br /> ❑ 885 Jarvis• DrI organ Hill, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 N° U U S 6 13 a 819 Striker AvdWite 8 • Sacramento, CA 95834 • (916) 921-9600 • FAX (916) 92100 <br /> ❑404 N Wiget Lane • Walnut Creek, CA 94598 • (925) 988-9600 • FAX (925) 988-9673 <br /> TOSCO (] 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 • FAX (707) 792-0342 <br /> C) 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 • FAX (650) 232-9612 <br /> Consultant Company lr� `��- Tosco Engineer Ed OV <br /> AddressB Site # <br /> City State Zip Code Site Addressp <br /> Telephone 170 7 ax# (70 7 _ City, state � pC W �- U <br /> Report To G� Sampler �e <br /> 1-"gr QC Data r� Level D (Standard) ❑ Level C Level $ ❑ Level A <br /> Turnaround I* 10 Work Days ❑ 5 Work Days ❑ 3 Work"bays ❑ Drinking Water Analyses Requested <br /> Time ❑ 2 Work Days ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water 6p <br /> L) Other n DRi) �`ti X51 x o <br /> Prosect Coding �A ,� <br /> �er�y��o�`�� z`'L�ao�P1��� <br /> Client Date/Time Matrix # of Cont Sequoia' �°� a� Az ��� ti Comments <br /> Sample I D Sampled Desc Cont Type Sample# �� �Q� <br /> 2 <br /> 0 <br /> � I <br /> 3 Cr <br /> a) <br /> U) <br /> 4 <br /> 3 <br /> 5 <br /> 6 } <br /> 7 <br /> A^ 8 O <br /> ` 9 Cr <br /> 1 <br /> 1 <br /> 10 as <br /> Relinquished By f s Date Time Received Date �( 1 Time _E <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Date Time <br /> Were Samples Received in Good Condition? ❑ Yes ❑ No Samples on Ice'? ❑ Yes ❑ No Method of Shipment Page of <br /> To be completed upon receipt of report <br /> t)Were the analyses requested on the Chain of Custody reportedl ❑Yes ❑No If no,what analyses are stili needed <br /> 2)Was the report issued within the requested turnaround time'? ❑Yes ❑ No If no what was the turnaround time? <br /> Approved by Signature _ Company Date <br />