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i <br /> 885 Jarvis Drive- Morgan N,11,CA 95x37• (408) 770-9600■ FAX(408) 782-0308 <br /> ° 008457 IN 819 Striker Ave,Suite 6- Sacramento,CA 95634 - (916)921-9600- FAX(916}921-0100 <br /> C]404 N.Wiget Lane•Walnut Creoic,CA 94598 - (925) 988-9600 ■ FAX(925)988-9673 <br /> SC0a 1455 McDowell Blvd North, Suite D- Petaluma,CA 94954, (707) 792-1865 - FAY,(707)792.0342 <br /> j OR( Ll 1551 Industrial Roast , San Carlos,CA 94070 • (650) 232-9600• FAX (650) 232-9612 <br /> Consultant Company :5Gc(,,L V kL1,G VAt-J.3 4 ST'S Tosca Engineer Lip (LAO-VIu.) <br /> A,ddress. P 1e-r Lt njt,_r 712.6 -Sv 1 W -- <br /> C,ty. ciao Co, ] h State,C-P, Zip Code -7SZ7 SbAddress 10%)6 [•4^ ngd' Sir <br /> Telephone 71 Fax# (11&j g'61_ ,btr 3 a City,State C.ar <br /> Report To ,y,s ,� Sampler -jNt.,,,*& A - QC Data Level D (Standard) ❑Levet C p Leve1 B p Level A <br /> Turnaround ;► 10 Work Days ❑ 61+ 9rk Days ❑ 3 Wark Days ❑ Drinking Water Analysas Requested IE <br /> lime. ❑ 2 Work Days ❑ 1 Warts Day ❑ 2 B Hours ❑ Waste Water <br /> Prolocl Coding- 1 - a'`$' �NO- y <br /> Clianl Date/Tme Matrix #of Cont Sequoia's Comments <br /> 10. Sampled Dese. Cont Type Sample# o d, <br /> r]f5 Sosfr.- 'Q 1 1..#3 a� 'I-AMt• <br /> 2. (r�P4t�J � Ia10 Jtic , <br /> LO <br /> i12Q `, <br /> 7 CV-4-5- S. <br /> zh <br /> 10 IYOO A,-1 • �- <br /> l am. Data 1 a Time Received Ely. Daie•C- G-z Time <br /> Relinquished By � �-Y � � <br /> r <br /> Relinquished By Daitel-41,0 - Trmo. 73Y Received Bi OizotRate. 1 Tine �� <br /> Relinquished By. date' Turn Received By. Date: Time. <br /> Were Samples Recopied TmGood Condition? Yes p No Sample$on Ice? Yes Q No Mothod of ShTpmeni. '�� � Page � of <br /> i <br /> To be Can+pleled ripen receipt at repoi1 <br /> 1)Were the artalyses requested on the Cttarn at Oustody reported? Ci Yes LINO rr no,what analyses we still needed? <br /> 2)Was rhe raport Issued wrthrn Urs requested tumwound time? Q Yes L-1 No It no,whalwas the turnaround trine? <br /> Appro _ Slgnaturo• - companir Date <br />