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N4 Ci ) ,u 9 ❑885 Jarvis Drive•Morgan Hill,CA 95037-(408)776-9600•FAX(408)81782-6308J' 9 Striker Ave Suite 8•Sacramento,CA 95834•(916) 921-9600-FAX(916) 921-0100 i C ��e C� ❑404 N \l iget Lane-Walnut Creek,CA 94598-(925) 988-9600• FAX (925) 988-9673 TOEl1455 McDowell Blvd North, Suite D-Petaluma,CA 94954-(707) 792-1865• FAX (707) 792-0342 0 ❑ 1551 Industrial Road•San Carlos,CA 94070•(650)232-9600-FAX(650)232-9612 Consultant Company /' 1 �y I i Tosco Engineer 1 Address �` �� _ Site# �, i L �� ✓�r�11 Cityr1 State �� Zip Code r7 f f Site Address ! + M W Telephone�+r f( �r �'L C� Fax# `, `L( ((& ,G'Email i City, State t ; ( kNVIP no 003 Report Tor ) { Sampler j i I !' E QC Data ❑ Level D (Standard) ❑ Level C [EEO]Level U Turnaround 10 Work ays ❑5 Work Das ❑ Drinking Water v"r irinalyses Requested y ❑3 Work ays I; S Y Time ❑ 2 Work Days ❑ 1 Work Day ❑2-8 Hours ❑Waste Water ❑ Other �O �o'` Project Coding ��~ ��If `mom �` Client Date/Time Matrix #of Cont Sequoia's .r A, �t O l Sample I D Sampled Desc Cont Type I Sample# �Q _ �Q O 0��'�V i Cohiments 1 a�' 1 — )dig �� r JV 2 }li,J n 1 4 cd E 4 ��TP `� n i l Cr 5 I cin 6 7 - f 8 MY101f 12- 9 Z9 c o E:I Relinquished By J Date f 3 Time Received B / l Date Time /,i.3pi Relinquished i3 1 q Y Date Time Received By Date Time _ Relinquished By 1 Date I.Time Received BV I Date Time .\ Were Samples Received in Good Condition t]Yes ❑ No Samples on Ice? ,U�Yes `❑ No Method of Shipment ;, Page of 'To\compieted upon receipt of report II 1)Were the analyses requested on the Chain of Custody reported? ❑Yes 0 No if no, what analyses are still needed? - i i- i 2)Was the report issued within the requested turnaround time? �❑Yes ❑ No If n what was the turnaround time? `► Approved Signature I Company Date