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TQS( Q (� kl 680 Chesapeake Unve•riedwood City CA 94063•(415)364 9600 U 18939 120th Ave N E,Suite 101 •Bolhell WA 980t 1 -(206)481 9200 <br /> UN O��L U 819 Sinker Ave,Suite 8.Sacramento CA 95834•(916)921 9600 U East 11115 Montgomery Suite 8•Spokane,WA 99246•(509)924 9200 <br /> U 404 N Wiget Lane•Walnut Creek,CA 94598•(510)988 9600 U 15055 S W Sequoia Pkwy Suite 110•Portland OR 97222•(503)624 9800 <br /> ' 5 ? 55 <br /> Consultant Company ') Project Name <br /> � LEC r,v - ;err -�� • r <br /> Address S y 4 O df�t9EAC Project Manager <br /> city � _ 51v Z7 -2335- <br /> City State C� Zip CodeI.Q AFE # <br /> Telephone �to g - li - 7,5-co FAX# -75 3c7 Site#, City, Slate O p A 4i C <br /> v <br /> Re ort Ta /j,' " Sam ler �! 111 6 it QC Data I-Level D(Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround 0 Work Days U 5 Work Das IJ 3 Work Das a_ <br /> Days y ❑ Drinking Water Anal ses Re nested <br /> Time LJ 2 Work Das �1 Work Da ❑ 2-8 Hours C� Waste Water <br /> CODE: Q Misc L] Detect �1=val U Remed ❑ Demol U Closure l�Olher �� ~� + �'� �� ��Z1Z <br /> Client Date/Time Matrix # of Cant Laboratory Q� Q � 8 + K/ <br /> Sample I D Sampled Desc Cant Type Sample# /.� /� V Comments <br /> 1 _ � <br /> �r L <br /> Q <br /> 3C cu r� ro <br /> 3 <br /> r_ �° <br /> 13!; � rr� <br /> tin o 5 <br /> qO <br /> 6 <br /> 3`5" nUT <br /> r T <br /> 17 <br /> If lead �scrrn, <br /> 10 El <br /> 0 <br /> i� <br /> o <br /> Relinquished By Date ,S Time =�� Received By Date f1 Time /z t3 <br /> Relinquished By Date Time /3KJ- ReceivedBy Date Time -E <br /> Relinquished By <br /> to Time I Received By Lab Date?O Time 13 <br /> Were Samples Received in Good Condition?❑Yes I:1 No Samples on Ice? 0 Yes 0 No Method of Ship t Page_of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? Ll Yes U No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? 0 Yes 0 No If no, what was the turnaround time? <br /> -:i _ ., <br />