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c t 001524 U1J24 U 885 Jarvis Drive • Akan Hill, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 • U 819 Striker Ave , Suite 8• Sacramento, CA 95834 • (916) 921-9600 FAX (9 16) 9?1 0100 mom'MWL.1,.LJ LJ 404 N Wiget Lane •Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988 C1673U U 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792 0 02 U 1551 Industrial Road * San Carlos, CA 94070 • (650) 232-9600 FAX (650) 21? 9612 ConsultantCompany ��+��_ Protect Name -------- ---------- YaM -- - - C- SPS Address TOSCO Engineer (required) City U p i State C q Zip Code 9 q56 S Telephone 625_�1_-15 5-5 X q == FAX # zS sir_?bg$ Site a, City,-State I8 7 —_ �k '1 , CA Report To ` Sampler ! �.I QC Data level D (Standard U Level C U Level B U Level A U t rr C��le►K�ticcK,� p ��[ 1--�-C�f�hatvta� }�1 > Turnaround U 10 Work Days `Pf-6 Work Days U 3 Work Days U Drinking Water Analyses Requested Time U 2 Work bays U Mork Day U 2 8 Hours U Waste Water CODE. U Misc U Detect U Eval U Remed U Demol U Closure U Other Client 1 Date/Time Matrix # of Coni Sequoia's �P��1 �QPan �P� QP�o1h vo°�� - ;Conirnenl-,Sample ID Sampled Desc Coni Type Sample _i_A)P -Zz3 31761—oqr Z UQR x X I M 3 IJP- 1 r ` /Ii ogoo x -� --- - 5 0-2-` 2-0 - X X t_ } Z-- 6a ---]::�::1000 �C X X7 M Z—AlbGstx X ------ 8 9 — --� - - - 10 Q) Relinquished By Date 761 Time �� Receivedf� �� () Time - -- - Relinquished By Date Time Received By Date Time Relinquished By Date Time Received By Date Time I Were Samples Received in Good Condition? U Yes U No Samples on Ice? U Yes U No Method of Shipment Page of To be completed upon receipt of report 1) Were the analyses requested on the Chain of Custody reported? U Yes U No If no, what analyses are still needed? 2) Was the report issued within the requested turnaround time? U Yes U No If no, what was the turnaround time? ---_ _