Laserfiche WebLink
" " O"lKei 5ulie 8 • Sacramento, CA 95834 - (916) 921-9600 FAX (916) 921-0100 <br /> Tosco -E 4 N.Wiget Lane *Walnut Creek, CA 94598 - (925) 988-9600 FAX (925 988-9 <br /> 673. <br /> ❑ 1455 McDowell Blvd, North, Suite D - Petaluma, CA 94954 - (707) 792-1865 FAX (07) 792-0342 <br /> LI 1551 Industrial Road - San Carlos, CA 94070- (650) 232.9600 FAX (650) 232-9612 <br /> Consultant Company: <br /> Address: �!�7 Project Name- <br /> City: t Sv �� �? TOSCO Engineer(required) <br /> State: Zip Code: S C <br /> Telephone: C C7 ZS S'�_ `{ � f -� <br /> SSY FAX #: <br /> Report To: U � Sampler:L Site #, City, State: 126 <br /> O � n � <br /> 1_aC�ST QC Data: ❑ Level D (Standard) LD <br /> Turnaround Work Das ) ❑ Level C 11 Level 6 U <br /> Time: ❑ 2 Work Days ❑ 1Work r Da ys ❑3 Work Days ❑ Drinking Water O Leve! A <br /> Y ❑2-8 Hours Analyses Requested <br /> CODE. ❑Waste Water <br /> �Misc. ❑Detect. C3 ❑ Demol.Eval. ❑Remed. �� � Ap � � <br /> ❑Closure ❑Other <br /> Client <br /> Date/Time Matrix # ofCont. <br /> Sample I.D. Sampled Desc. Cont. Sequoi ' <br /> Type5ample # Q�`� .��'�- 0`� �� ��� <br /> 1. Jona `` Comments <br /> 2. X <br /> 3. <br /> 'o <br /> 0 .. <br /> 4. 0 <br /> r aD <br /> 5. <br /> CXLVU T <br /> 6. <br /> 7. <br /> 8. <br /> 9. <br /> 10. <br /> m <br /> Relinquished By: <br /> Cr <br /> Date: lr ,u,J lime; m <br /> Received By: cn <br /> q Y <br /> 8 : 7 <br /> Relinquished Date: _ .0 Time: ' <br /> �_ <br /> ate: Time. <br /> Relinquished By: 7 /15 Recei <br /> t e: Receiv � <br /> Were Samples Received in Goad Condition? : Dat 7 �� 17; /s <br /> ❑Yes Cl❑No Samples on Ice? ❑Yes ❑ Time: <br /> No Method of Shipment <br /> To be completed upon receipt of report: <br /> 1) Were the analyses requested on the Chain of Custody reported? Cl Yes ❑ N page <br /> of <br /> — <br /> 2)Was the report issued within the requested turnaround time? ❑Yes ° If no, what analyses are still needed? <br /> Approved by: LI No If no, what was the turnaround time? <br /> Signature. <br /> Company: ,.� — <br />