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❑885 Jarvis Drlve• organ Hill, CA 95M7, (408) 776-9800• FAX (408) 782-6308 <br /> . N! 007301 )ff 819 Striker AveWe 8 •Sacramento, CA 95834• (918) 921-9600 - FAX (916) 921-01. s <br /> U 404 N Wiget LaW-Walnut Creek, CA 94598• (925) 988-9600•FAX (925) 988-9673 <br /> TOSCO E) 1455 McDowell Blvd, North, Sufte D- Petaluma, CA 94954• (707) 792-1866• FAX (707) 792-0342 <br /> Q 1551 Industrial Road •San Carlos, CA 940701 (650) 232-9600•FAX(650) 232-9612 <br /> Consultant Company Ae Cav Tosco Engineer_ Ell Q1PL f 7-'V..t <br /> Address { rf S'f site# till Z <br /> CFS' !t Co�crvc�4 State ef} Zip Code Site Address <br /> d Crr;nf�t ��-t/ Z ,- <br /> C <br /> Telephone ?Cl- ogoo Fax#, OLJ 3p City, State F,foc)l��O;j C'4 <br /> U' <br /> Report To ,S �..� Sampler �,0 QC Data. Level D (Stan ard) ❑Level C ❑Level B ❑Level A <br /> c <br /> himaround 9P 10 Work Days ---❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water Analyses Requested (- <br /> time, p 2 Work Days ❑ 1 Work Day p 2-8 Hours ❑ Waste Water <br /> © Other <br /> Project Coding <br /> Client DateMme Matrix #of Cont Sequoia's �Q� Q��` Comments <br /> Sample I•D, Sampled Desc, Coat Type Sample# o <br /> K:v. � zo -32. Wog ti <br /> �e! 4er, Ix <br /> 3 <br /> 4 <br /> 5 �O <br /> 6 <br /> 7 <br /> 9 o <br /> g <br /> m <br /> Relinquished By Date 11-y,,vi Time; 11:3D Received Da Gf Time, �v <br /> Relinquished By, �- 1 Time,/-7 -Cr Received 4nate,�" ( Time , <br /> Relrn uished l8 Date Time Received By Date: Time <br /> Were Samples Received In Good Condition? ❑ Yes ❑ No Sarnptes on Ice? G Yes ❑ No Method of Shipment Page of <br /> To be completed upon(ecelpt of report <br /> 1)Were the anaiysas requested on the Chain of Custody reported? Q Yes ❑No If no,what analyses are still needed? <br /> 2)Was the report issued within the requested turnaround ilme? ❑Yes Q No If no,what was the turnaround tame? _ <br /> Approved by Signature company' Date .. <br />