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• a ❑ OBS Jarvis Drisorgan Hill,CA 95637• (408) 776-0640•FAX(408) 782 6306 0 <br /> N- 0 0 8 5 3 8 `d 819 Striker Ave, Surfte 8 -Sacramento, CA 95834 ■ (918)921-4500•FAX(916) 921-0 100 <br /> ❑404 N Wiget Large-Walnut Creels, CA 94598* (925)968-9604- FAX(925) 988-8673 <br /> Ubco ❑ 1455 McDowell Blvd North, Suite 0 - Petaluma, CA 94954 a (707) 792-1865- FAX(707) 792.0342 <br /> ❑ 1551 Industrial Road •Seal Carlos,CIL 94078- (650] 232-9600* FAX(650)232-9612 <br /> Consultant Company #=c,,,t,. Tosco Engineer. SMO <br /> Address* '3(,,v7 L(too ct .moo,. S.. t TL-I0h szto# I S <br /> City 1 ,,,aa.srEr t a,,p,,Sfate C^, Zip Code ` 6' c" Site Address: +��t D h+•jr r [a(,r13 ��� <br /> Telephone (9f6)t6i--o,1 Fax 4 ( yjgi'�ce(.y-o`r30 city,State, <br /> Report To s tr..s us Sampler -}��.v.�.� P�-sc QC Data Level 0 (Standard) G Level C ❑Level B p Leval A <br /> c <br /> Turnaround �Olt 10 Work Days ❑ 5 Worm Days ❑ a Waris mays rJ Q(Inlung Water Analyaes Requested a <br /> Time- U 2 Work Days ❑ 1 Work Oay C] 2-8 Hours ;t Wasle Water <br /> - <br /> Other `s' <br /> Biotest Coding ',� sp5Client Dateme ��° , <br /> Sample I D Sameed Desrc Cant Type sample# � 0 �c�Q �'�o Comments <br /> 1 jhW-12L.1S f 11100.7— agar arm ( 6 111 ) D'kvit,--A6 Im,& <br /> 2 0140-1Le-Eof 4 'ifs t"'r X-ML'- - <br /> 4 <br /> . <br /> 9. <br /> ty <br /> 10 _ <br /> Relinquished try Date �fL Time 41 d Received B _ Date � Time 0 <br /> Relinquished By _ Rate• - '-v - TIM q:L�n Rocoived <br /> Relin ulshed By. Date: I Time I Received By I Date Time. <br /> Were Samples Received in Good Condillon? Yes t] No Samples on fee? fes L) No Method of Shlpment,T Page of <br /> To bo completed upon recsrpl of vapors <br /> ti)Were the anatgses requested on the Cham of Custody repoited'; O Yas a He it no,what analyses ate still neededg <br /> 21 Was the report issued within the requested turvarnund time? U Yes 011a HAD,Mist was the lu matound%=7 <br /> Approved by Srgnaiurs _._ Company Data <br />