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x <br /> (�U .1<<� , ,J ou:, ,/al v15 U!ive * lvwi ya.i 11111, UA yJju,tr * t4Uo) I.U-JUUU • 1 AA t4UU) I U&UJUU <br /> U 819 Striker Ave , Suite 8 Sacramento, CA 95834 (916) 921-9600 FAX (916) 921-0100 <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 I <br /> U 1551 Industrial Road - San Carlos, CA 94070 - (650) 232-9600 FAX (650) 232-9612 I <br /> Consultant Company Protect Name1 DR <br /> �o s co 6 �Z�� �ST lTc.+�►+i-asr <br /> Address Glc{ SICrrc, 6� le 7 TOSCO Engineer(required) �W►i j L <br /> City i State G4 Zip Code c�yS. W j 0 s 5 3 <br /> Telephoneite , City, State qZs- FAX # S # t <br /> "�-- -- fit( oGk4m CA <br /> Report To 11.5 Lcc Sampler - s OC Data Level D (Standard) U Level C U Level 8 U Level A <br /> Turnaround U 10 Work Days rA Work Days U 3 Work Days U Drinking Water Analyses Requested <br /> Time U 2 Work bays U 1 Work Day U 2-8 Hours U Waste Water asp ��� %,C <br /> CODE: <br /> CODE: U Misc *elect U Eval U fiemed U Demo! U Closure >40ther �� �\ \ �� \`S <br /> Client Date/Time Matrix # of Cont Sequoia' Qp��h � ,� QP��S ��ks vo�\`�� <br /> Sample I D Sampled Desc Cont Type Sample # � Comments <br /> /2 g1-1 Nao vast S C 1 AS it ✓ <br /> i 3 - <br /> 4 —— O9- <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 10 <br /> Relinquished By Date S712 J11aL Time �7; 2,0 Received By lttvAf.,A . Date S 2�(- Time / 1 , Zp <br /> .;;,-����— Z_ <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? U Yes U No Samples on Ice? U Yes U No Method of Shipment Page—of_ <br /> To be completed upon receipt of report <br /> 1 Were the analyses requested on the Chain of Custody reported? U Yes U No If no, what analyses are still needed? <br /> _�.�, as the report issued within the requested turnaround lime? I U No If no, what was the turnaround time? ^ <br />