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❑ 85 Jarvis Drive • an HILI, CA 95037 - (408) 776-9600 - FAX (408) 782-6308 <br /> 001168 U <br /> Striker Ave , S - Sacramento, CA 95834- (916) 921-9600 FAX (916) 921-01009 <br /> ❑404 N Wiget Lane•Walnut Creek, CA 94598 - (925) 988-9600 FAX (925) 988-9673 <br /> TU 1455 Blvd CA 94954 o OSCO U 1551 IndDustriall Road NSan,CarlSuite <br /> s, CA 94070 Petaluma,6 0) 232 96000 FAX 650792-1865 32-612 7) 792-0342 <br /> f ) f ) <br /> Consultant CompanyProject Name L' - - <br /> Address 67q 7 ;er '�Doi �e_ J TOSCO Engineer(required) k)IJ <br /> City b StateLA Zip Code s68 <br /> Telephone f� _ s� - 75�`S�( ��� FAX # CIZT-557- 7W Site #, City, State Ol 7 6 <br /> Report To SamplerOC Data Level D (Standard) ❑ Level C ❑ Level B U Level A U <br /> Turnaround U 10 Work Days 5 Work Days U 3 Work DaysIL allaAf&dAft I az&f� 1 6' ❑Drinking Water Analyses Requested <br /> Time U 2 Work Days U 1Work Day ©2 8 Hours <br /> U Waste Water �ti ary <br /> AQP �Q <br /> CODE: U Misc U Detect ❑ Eval Remed ❑Demo! 0 Closure U Other <br /> Client DatelTime Matrix # of Cant Sequoia's �`°� `�`P� \P�� �\at� F�' Comments <br /> Sample I D Sampled Desc Cont Type Sample # �Q� ��`� ��� �QZ` Jona �A <br /> 1 ►uP-1 -2Z '51,Rto I fiffacr 2 oA x <br /> 2�� s oo !O - -- <br /> Cr <br /> �P1iL ae s <br /> 4 0 <br /> 5 Z—7_D M6 VC } <br /> 8 <br /> �� r a x <br /> b- <br /> 9 <br /> 10 ��C o <br /> m <br /> Cr <br /> Relinquished By __ Date S 4 f Time 330 Received 13 le Time`4 =—_ m <br /> Relin(iuished By Date Time Received By Date Time 3:Relinquished By Date Time Received By Date Time <br /> Wale Sanii,les HLceived in Good Condition? U Yes U No Sarnples on Ice? UYes U No Method of Shipment _ _ Paige _ of <br /> To be completed upon receipt of report <br /> t) Were the analyses requested on the Chain of Custody reported? U Yes U No If no, what analyses are still needed? _ <br /> 2) Was the report issued within the requested turnaround time? u Yes U No If no, what was the turnaround time? <br /> Al moved by Sir}nat+ire Company nalo <br />