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01476 •-• ��� %ia"via uiwd mutyd.t 1-11111, UA `.10W/ - (4Ud) !/b-ftUU - FAX (408) 782-b308 <br /> U <br /> 11 1 6 C) 819 Striker Ave , S Sacramento CA 95834 - (916) 921-9600 FAX (916) 921-010 <br /> }O ❑404 N Wiget Lanellnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 00 <br /> V CYN, 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 e' Project Name <br /> Address `2 ? e ` TOSCO Engineer (required) <br /> ► <br /> City ubl-.A State, Zip Code q 96F. <br /> Telephone s _ 4. ����' FAX# qZ. ,551_'� 0 Site #, City, State <br /> Report To PA Sampler <br /> OC Data .Leve! D (standard) ❑ Level C ❑ Level B ❑ Level A v <br /> Turnaround U 10 Work Days >i Work Days ❑3 Work Days U Drinking Water Analyses Requested Y <br /> Time U 2 Work Days ❑ 1 Work Day ©2-8 Hours a <br /> ❑Waste Water <br /> CODE: U Misc ❑Detect ❑Eval EllRemed ❑Demol 0 Closure ❑Other <br /> .1k ��\�S� <br /> Client Date/Time Matrix # of Cont Sequoia's QP°°1 yep°°� �h � <br /> Sample I D Sampled Desc Cont Type Sample # 1Q�� ��� ���� �Q��Q ��°~`° �����o Comments <br /> �p- 1- <br /> - - 2-7sZ t2, 0�� vA510100701 C �C Wol <br /> -- <br /> noq <br /> 3- P - l off' -o U) <br /> 4� 2— 7-0 mss y <br /> 0 <br /> -5 ba �ai5 -05 X k <br /> s <br /> 7 <br /> 8 <br /> 9 0 <br /> I co <br /> 110 0 <br /> Cr <br /> Relinquished By Date 2/b/ Time 1X30 Received B to 1t Time <br /> _ m <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Date Time <br /> Were Samples Received 1n Good Condition? ❑Yes ❑No Samples on Ice? ❑Yes ❑No Method of Shipment Page of <br /> I 9 <br /> To be completed upon receipt of report <br /> 1)Were the analyses requested on the Chain of Custody reported? U Yes ❑ No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? U Yes CJ No If no, what was the turnaround time? <br /> Approved by -- -- -T Signature Date -- - <br />