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N 12 0 U 2777 i-I 88!j Jarvis Lime o IVIUiyati t lite, UA J�)UJI • k- Wv) f ,u uut,v , , k Wv� , .L <br /> ❑ 819 Striker Ave , Suite 8 • Sacramento, CA 95834- (916) 921-9600 FAX (916) 921-0100 <br /> U 404 N Wiget Lane*Walnut Creek, CA 94598• (925) 988-9600 FAX (925) 988-9673 <br /> Tosco U 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> ❑ 1551 Industrial Road • San Carlos, CA 94070• (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company C-4-Atr Ryc.h TKG� ti d Los",o Project Name 31p3 We a f � �r•,�er L4+ae <br /> Address ( 5; Gf Su� e T TOSCO Engineer (required) �� Tr'�!G <br /> City cub);h State eA Zip Code q qSg J� O <br /> Telephon Q ss�-��rs-,r FAX #{�#�S Sl1- �8d8 Site #, City, State /�i93 5Toc/�4h 0 0 C� <br /> Report To �e Lee- Sampler QC Data XLevel D (Standard) ❑ Level C ❑ Level B ❑ Level A U <br /> ac <br /> A. <br /> Turnaround U 10 Work Days 5 Work Days U 3 Work Days U Drinking Water Analyses Requested EL <br /> Time U 2 Work Days U 1 Work Day U 2-8 Hours ❑Waste Water %ti <br /> CODE: U Misc Xpetect U Eva[ U Remed U Demol ❑Closure XOther a °l �o\ � 5 <br /> Samlile I D Sampled Desc Cont Tone Sample le # Comments <br /> Sample p yp p e� J <br /> 1 MSW- I R 8 /3/o/ Hs4 3 VW voAs ✓ ✓ ✓� � <br /> 0 <br /> 2 MW- ZR <br /> 3 VW_ I ✓ �' ✓ u] <br /> 4 3 <br /> 5 } <br /> 6 <br /> 7 <br /> 8 <br /> 9 ro <br /> 0 <br /> 10 a <br /> m <br /> Relinquished By Date�� . Time (yZr� Received By ` �ajj Date g Time <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) W re the analyses-requested on the Chain of Custody reported? ❑Yes EI No If no, what analyses are still needed? <br /> 2)�the report issued within the requested turnaround time? ❑Y ❑ No If no, what was the turnaround time? <br /> C,nnafi,ra <br /> _ Company ____ _... e <br />