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i <br /> Li is 19 Strixer r,ve ti N 'tc a Liau'ainw k1o, CA 65534 ■ (u iu) 921-9600 r %X (y I!-, .,L I u <br /> l7 404 N.Wiget Lae ;W JValnul Creek, CA 94598 - (925) 988-9600 FAX (925) 988-9673i":.'-1:;." <br /> ❑ 1455 McDowell Blvd. North, Suite D - Petaluma, CA 94954 - (707) 792-1865 FAX (7i~' X92-0342 <br /> Tosco ❑ 1551 Industrial Road - San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company: 3.O Project Name: f r7 <br /> ef — <br /> A 6C <br /> Address: C.-N-7 S Cf z l C_ T TOSCO Engineer (required) <br /> City: h State: C& Zip Code:17q ,�`CS-- <br /> Telephone: c"�S SS(�7SSS FAX # r7zS 1, - Site #, City, State: U/JS 165 s` :s 14 1 --- <br /> Report To: o Sampler: DC Data: ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> U <br /> d ueste <br /> Analyses Re C <br /> Turnaround p(1 ork Days ❑5 Work Days ❑ 3 Work Days O Drinking Water Anal y q a <br /> Time: ❑ 2 Work Days ❑ 1Work Day ❑2-8 Hours ❑Waste Waterer Q0"� <br /> CODE: ❑Misc. ❑Detect. ❑ Eval. ❑Remed. ❑ Demol. ❑ Closure ❑Other <br /> Client Date/Time Matrix # of Cont. Sequoia's QP� `N ������ ��° � v°� Qc Comments <br /> Sample I.D. Sampled Desc. Cont. Type Sample # ..,(�J <br /> a� <br /> 2. cn <br /> 3. o <br /> 4. <br /> 5. <br /> 6. <br /> 7. <br /> 8. <br /> R <br /> 9. T <br /> c <br /> 10. u <br /> Relinquished By: ate:f Job Time: `3 Received By: Dale: 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? 0 Yes ❑ No Samples on 1ce? ❑Yes ❑No Method of Shipment Page`of <br /> To be completed upon receipt o1 report: <br /> 1)Were the analyses requested on the Chain of Custody reported? ❑Yes ❑ No If no, what analyses are stili needed? <br /> 2)Was the report issued within the requested turnaround time? ❑Yes ❑ No It no, what was the turnaround time? <br /> Approved by: Signature: Company: Date: <br />