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TOSCO 404 N.Wiget Lane •Walnut Creek, CA 94598 • (925) 988-9600 FAX (925)' <br /> 988-9673 <br /> ❑ 1455 McDowell Blvd. North, Suite D • Pelaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> ❑ 1551 Industria! Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company:{TF—:-rTL-P—ft— ftJ RP J JJC r Project Name: S C � ' 9 S ! L Q O <br /> Address: 6�4 S wa% �T, Sir`� 37 TOSCO E=ngineer (required) C D <br /> City: "Ll <br /> L` A) State: C R Zip Code:9 4- J b g ' 9�fC?Q! Iv <br /> Telephone: �� 51 5 5-5 FAX #:5-15 _ Site #, City, State: 16500 SO LITHu I R-5-FaTr E 5 <br /> Report To: Dp ul7' sampler:—RIC OC Data. evel D (Slandard) ❑ Level C ❑ LevelB ❑ Level A U <br /> Turnaround X10 Work Days ❑5 Work Days 113 Work Days ❑ Drinking Water Analyses Requested /V1 <br /> Time: ,❑ 2 Work Days ❑ 1 Work Day ❑2-8 Hours a <br /> ❑Waste Water <br /> a <br /> CODE: ❑Misc. ❑Detect. ❑ Bval. ❑Remed. ❑Demol. ❑Closure `Other <br /> Client Matrix # of Cont. Sequoia's <br /> Sample I.D. Desc. Cont. Type Sample # �Q�'� ��� �10``� �Q�`a �o\a`�e. � .( Comments <br /> 1. -- CO DF��1 41 4 AW o)A—C, <br /> 2. o <br /> 3. <br /> 4. <br /> 3 <br /> 5. } <br /> 6. <br /> 7. <br /> 8. <br /> 9. <br /> 10. � <br /> c <br /> (D <br /> Relinquished By: Date I. <br /> Time: Received By: Date: Time: <br /> 4 <br /> Relinquished By: Date: Time: Received B r <br /> Y: Date: Time: <br /> Relinquished By: Dale: Time: Received By: cu Date:/ /D <br /> C � I99 Time: / 7 : 0 <br /> Were Samples Received in Good Condition? Yes D No Samples on Ice? Yes ❑ No Method of Shipment e Pag ^of <br /> To be completed upon receipt of report: <br /> 1)Were the analyses requested on the Chain of Custody reported? ❑Yes ❑ No If no, what analyses are still needed? <br /> 2)Was the report issued within the requested turnaround time? ❑Yes ❑ No If no, what was the turnaround time? <br /> Approved by: Signature: <br /> Company: DF", <br />