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i I <br /> Q 885 Jarvis Dorgan H-11111,CA 95037- (408) 776-MD- FAX(408} 782-MOS <br /> N° 007232 1 s19 Striker Avd.We Be Sacramento,CA 95834- (918) 921-9600 - FAX(916)921-151 <br /> 0 404 N.Wiget Lane s Walnut Creek,CA 94598 - (925) 988.9M - FAX (925)M-9873 <br /> i 0 )f'upo, )I U 1455 McDowell Blvd,North, Sure D- Pe1flduma,CA 94954- (707) 792-i8B5 - FAX(707)792-0342 <br /> ❑1551 Industrial Road - San Carlos,CA 94070• (650) 232-OM - FAX(W*) 232-9612 <br /> CORSuitarrt Company S`ecorr Tosco Englnaor igFdl R -cTJ409- <br /> City. Ciro ' r<dob/, Stab' C dip Gade' , 'G ?c.> Site Address' 1464170 <br /> Telephone. g .. /r 0V00 Fox#• f 6/_c>q7oCity,5#ate, � - m <br /> ro.; <br /> Report To fLvS f y (3eqAfvfAy I Sampler: QC Data Level D(Standard) ❑Levei C [2�evel B Q evel A <br /> Turnaround $1 10 4lrark nays U 6 Work Days (3 3 ftrk Days ❑ Drrnkmp Water An*ses Requested nom. <br /> Time: 2 Wank Days ❑ 1 Wvdc Day 17 2-8 Hours ❑ Wasto Wator <br /> p 01ber <br /> �1 0 <br /> Project God14 <br /> Client DaWrIme Matrix R of Cont. se uoia`s o <br /> Sample 10. Sampled Dew. Cont. Type Swlple# Comments <br /> 2 rW Ahs--6 i ?uol' <br /> 3 3 961fds <br /> iD _ <br /> h <br /> Relinquished By. Date,T-7-;tUl Tim ms Recery Tirt�t?� <br /> ReGnquishecl«E3y; f]a�- TimaReserved B a rune <br /> Refiragrflstled B <br /> Data, Trme: Received BY, Date: Tune. <br /> Were Samples RecowO tir Good Rion? ❑ Yes ❑ No Samples on Ice? U Yea ❑ No Method of Shipm M. I Pago-- --of <br /> To 6e complated upon raaeipt of report; <br /> t)Were ft enalysaa requested on the Chaln al Custody reportod? U Yoa (3No if rm.what a rWyses are sp11 needed? <br /> 2)Was the fepott Issued ueth m the requastr d tumtaraund time? ❑Yas Q No tf nu,what arae Ihs turnerou nd tulle? <br /> Approved by: Signature Gompernr <br />