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IN <br /> C] 8135 Jarvis OTIV6 n 11111,CA 85037■(4M)776-9600•FAX(408)782-SMS <br /> N9 010167 <br /> 19 819 Striker Ave.,Sults 81,Sacramento,CA 95034 a (918)921-9900 o FAX(916)921-0100 <br /> E]404 N.Vjget Lane e Walnut Creek,CA 94598, (925) 088-9600 a FAX(925)988-9673 <br /> AX22hk 1 <br /> • <br /> 0 1465 Mc ill Blvd.North,Suite 0 0 Petaluma, GA 94954 -(707)752-1885- FAX (707)7ez,03 42 <br /> %JSCU 0 1551 Industrial Road San Carlos,CA 94070 P,(660)282-9600-FAX(6501232-90112 <br /> 16 (ACJ VTosco EEngineer:: <br /> MA <br /> Address: <br /> State: ite Add <br /> s <br /> City; Sta zip Godo, q q 3 if <br /> Telephone: -55 Fax 4 Vj_)):jg Email. V05,�kj ry city, State: <br /> [70-7 7 <br /> q <br /> (707) —3) JK 0 <br /> Bata= 0 Level G(Standard) F.1 Level 0 Level 13 El Level A <br /> ot I To, Samplur. <br /> Rep <br /> -Sav Id- V-P:K[eA L e 0 ffrk-V er Ar QC D <br /> PrinNing Wailer Analyses Requested <br /> Turnaround 031OWork pays UaWork Days F13MIkDays <br /> Time: ❑ Markl)ays [11Work Day ©2-8 Hours Wastewater (L <br /> t. <br /> E]Other <br /> Pcoject Coding: <br /> Chant oatoFl rn�_ Matrix #f of cont, sequoia's Comments <br /> sampto I.D. Sampled baso. Cont Type Sample <br /> 2. 3 <br /> 7. <br /> P <br /> -0 <br /> 'Cate- Time, Timals <br /> Relinquished By. <br /> ; <br /> Flellnquished By. Time, ReceiM Ely,. DaleTime', <br /> 'rime, Received By., Dale. Time: <br /> FlelinquIshed By,, Dato. <br /> Mere SamptasReceived!nGood Condition: []yes E3iso Samples an lee7nYe s No Method of Shipment pagl� of <br /> _ F] <br /> To be completed upon receipt of roport; <br /> 1)Woro tha analysoa requested on the Chain of Custody[Eported? ;K)'os E3 No It no.Nvrat anutyses af-C still needed? <br /> 2)Was the report Issued wilhin lha iequesf ed turnaround time? (I Y04 VMo if no,what oras/the turnaround frme? <br /> Approved by. 5[gnattir -------Company, Date', 7-(2 s <br /> ------------------ <br />