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fi(680 Chesapeake Drive-Redwood City,4k,63-(415)364-9600 U 189391201h Ave,N E,Sude 101-BodW,WA it-(206)Qi-92o0 <br /> GUILO O 819 Striker Ave.Suite 8-Sacramento,CA 95834-(916)921-9600 © East 11115 Montgomery,Sate B-Spokane,WA 992206-,(509)924-9204 <br /> UN ., 1900 Bates Ave,Suite LM-Concord,CA SWO-(5 10)686x9600 0 15055 S W Seth Pkwy,Std 110-Poniend,OR 97122-(503)624 <br /> Company Name "` Project Name S p Ci(�jtf!c/ <br /> Address oNOCAL Project Manager <br /> City C'�e37+/[� State t Zip Code <br /> ele hone ,570 6 0 2 s' j)Q FAx#. Site# 2 59T <br /> Report To Wler 2auQC Data ❑ Level A (standard) ❑ Levet B ❑ Level C ❑ Level D <br /> Tumaround §k10 Working Days ❑2 Working Days ❑ Drinking Water [Analyses Requestedl <br /> Time: Q 5 Working Days ❑24 Hours ❑ Waste Water <br /> ❑ 3 Working Days ❑2 -8 Hours ❑ Other <br /> Client Date/rime Matrix #of Cont Laboratory <br /> Samoa I D Sampled Desc Cont Type Sample# , Comments <br /> 1k1_11-S3 Vol [ 1 R <br /> 2 RU L4 U il I x <br /> 3 14if 41 <br /> 4 <br /> 5 f t� <br /> 6. <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> Relinquished By Date Time ; S`0 Received By Date 11-13-fXTime <br /> Relinquished By. Date E Time Received f3 Date Time r "� <br /> Rehri [shed B ' Date t Time Received B Date Time <br /> I <br /> Were Samples Received In Good GonditionlP Yes 0 No Samples on ire?V9 Yes Cl No Method f Shipment Page of <br /> To be completed upon receipt of report, <br /> 1) Were the analyses requested on the Chain of Custody reported9 Q Yes a No If no, what analyses are still needed?--- <br /> 2) <br /> eeded?_ ___._2) Was the report issued within the requested tumaround time? ❑Yes❑ No tl no, what was the tumaround time'?--- <br /> Approved <br /> imes _—Approved by, Slgnaturo __ - -Company �__ _�--_-- - Date <br />