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Ll 885 Jarvis Drive - Morgan Hill, CA 95037 - (408) 776-96OU - FAX (outs) ittl-tium <br /> : p 819 Striker Ave., Suite 8 - Sacramento, CA 95834 - (916) 921-9600 - FAX (916) 921-0100 <br /> Q 404 N. Wiget Lane - Walnut Creek, CA 94598 - (925) 988-9600 - FAX (925) 988-9673 <br /> TOSCO 1d 1455 McDowell Blvd. North, Suite D - Petaluma, CA 94954 - (707) 792-1865 - FAX (707) 792-0342 <br /> Q 1551 Industrial Road - San Carlos, CA 94070 - (650) 232-9600- FAX (650) 232-9612 <br /> Consultant Company: _�, p `���t"L`� 2 Tosco Engineer: <br /> - <br /> Addtess: _ 1 , Site #: <br /> City: <t�Kn Stale: CA zip Code. C'L�; Site Address: y7O? ac rAve, -- <br /> Telephone: c Fax u �I j City, State: oak}p <br /> Report To ?' kt --T-Sar plcr �'(- t��c OC Data: p Level D (Standard) ❑Level C p Level B Q Level A Y <br /> Turnaround J 10 Work Days 5 Work Da" -1 3 Murk Days J Jnnkinn 44atur Analyses• Hetluesied al <br /> Time: J ? Work Days J t Wo+k CrayJ 2.3 NuiuS J WaStO 4V;;U:I <br /> 00 <br /> f�rtsl@c Coding: , .Ilk 4`� c` � ---- <br /> Client 1 L);Ne)Timt7 l A nl'ix 1 n of 1 Cnrt �"Ptjltoil'5 ti'i" �? /,�' �f�"L / <br /> Sample LL). I Sampled j Dcsc. Cont. I 1yi�c� XV 10 <br /> Sample tj <br /> e""' f /C; <br /> o^uncr is <br /> z f _� <br /> 3=- --- --- - - -- — - - _� ...-j __--�--- <br /> ,,i A.ER CU ' Jf)Y SFALS INTACT Q <br /> i <br /> 10. _� - -- -�-- -- -t- <br /> 1 .. <br /> r / / ' <br /> Relinquished BY ` L_a_. Date: (L�21 Timta: Recc°ivad C�yT G"�- - '2�jL��x [sate., Time: <br /> Relinquished By: - -- - - Date-. --- Time. t3yDal 0- Time: <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> Were Samples Received in Good Condition? Q Yes ❑ No Samples on Ice? O Yes O 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 reported? Q Yea ❑Na If no,what analyses are still needed? <br /> 2)Was the report issued within the requested turnaround time? ❑Yes 0 No If no,what was the turnaround time? <br /> Approved by:f Signature: Company - Date: <br />