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002770 U 885 Jarvis Drive - Morgan Hill, CA 95037 - (408) I76-9bUU • FAX (408) 182-6JU8 <br /> U 819 Striker Ave , Suite 8 - Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> ,X404 N Wiget Lane -Walnut Creek, CA 94598- (925) 988-9600 FAX (925) 988-9673 <br /> TOSCO Ll1455 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 ffkr _ R 'Z&%C <br /> Project Name -7b5cO Form- 13p .2 <br /> Address 679 GY r s G�- S�i T TOSCO Engineer (required)71 <br /> r <br /> City n` 9 1,h State CA Zip Code S � C; <br /> Telephone ZS_ SS!- �Srs— FAX # cr2S7)$-:r SEfI Site #, City, State 11191 77-r c °' <br /> U <br /> Report To �� �Le Sampler s�� �, QC Data Level D (Standard) ❑ Level C ❑ Level B C3 Level A Y <br /> Analyses Requested] <br /> Turnaround U 10 Work Days )4 5 Work Days U 3 Work Days Q Drinking Water Y0- <br /> Time <br /> Time U 2 Work Days U 1 Work Day U 2-8 Hours ❑Waste Water a, �5�\ QP%X �pVO <br /> CODE: U Misc U Detect U Eval U Remed U Demol U Closure Other <br /> �°�h Pati Qp�� <br /> Client Date/Time Matrix # of Cont Sequoia's �eP �` ��� `� �� w° Comments <br /> Sample I D Sampled Desc Cont Type Sample # �Q� ��`� �� �Q� �o� �e <br /> 1 0 -w 5-12 YY-1 1�=0 ca <br /> V . J ✓ ✓ <br /> a <br /> 2 <br /> 3 0 <br /> 4 M/ " 0 2 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 a <br /> a <br /> 10 <br /> CV � <br /> Date 2 a/ Time f Received By Date 5/21/0/ Time 171, 20 <br /> Relinquished By Z s <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Date Time <br /> Were Samples Received in Good Condition? U Yes ❑No Samples on Ices U Yes ❑No Method of Shipment Page—of <br /> To be completed upon receipt of report <br /> J$ere the analyses requested on the Chain of Custody reported ❑Yes ❑ No If no, what analyses are still needed? <br /> as the report issued within the requested turnaround time? l U No If no, what was the turnaround time? <br /> Annrnvori by Sianature Company _ _ _ —Date _ <br />