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No 010175 C7 885 Jarvis DrIve+Morgan Hill,CA 95037•(jiM 776 9$00• FAX (408)782 530E <br /> #819 Striker Ave,Suite 8■Sacramento,CA 95834v(918)921 9600- FAX(916)921-4100 <br /> 404 IN Wiget Lane•Walnut Creek,CA 945981(925)989-96013 P FAX(925)968 8878 I <br /> TOSCO <br /> U 1455 M000well Blvd North,Suits D•Retaluma,CA 84954•(707)792-1865 9 FAX(707)792-0342 <br /> t55J Indus dal Road•San Carlos,CA 94070 (M)2$2 9600+FAX(650)232-9$12 <br /> Consultant Company f aC 41 le Y- y Tosco Engineer <br /> - Address 13 I , Site P <br /> T City� Jt'' til t#r�lflfl Gi Stale Zip Code EL, Site Addoass �T0 t1/ �' <br /> Telephone � T0� 7 � Fax� o � - Email � �l re �iC�C city,stat f l ��0� �!i{O rNi � <br /> tiel�arl To Sxmplec L' i �P F +f 7j QC Data fQlr t avr�l P(5landarti} ❑Level C n Level O ❑levet A U <br /> Turnaround dni0 Work Days ❑6 Work a tys Lj 3 Work Days Q Dnrl$n9 Water Analyses Requested c <br /> T�rr�e. 0 2 Work Days Lj1 Work Day ❑2-S HoursOther <br /> ❑Was1e Waterer a <br /> Protea Coding x <br /> Chant DataMme Matnx #of Conl Sequoia's .z' <br /> Sample 1 G Sampled Desc Cont Type Sample# Q 4 Comments <br /> n 1 ". 7 1 <br /> 2 M1 e� 0 <br /> 3 cu <br /> -- o <br /> 4. _ _ - Z <br /> - <br /> 7 _ <br /> Pulinqurshed By _r_ Dato Q Time t / Rece1v d _ Rate Time{ <br /> Rellaqulshed By_ Date! Time. Received By, - _ Date Time <br /> l <br /> Relinquished 13v _ Oate Trmo Recelved By Bate Time <br /> Ware Samples RecelyQd in Good Condition ❑Ycs ❑Ho Samples on tce? (]Yes ❑No Method of Shipment Page of <br /> To he completed upon recerpt Of report <br /> 1)Wom the analysos requested on the Clteln of Custody reported? gYes ❑No H nn,what ana[yses are still needed? <br /> 2)Was Jho roport ls9ucd within the requested turnaround bine? dyes ❑No If no what was the to around time? <br /> Approved by�d.. d J� �'Ors� S[gnalure�_� Company �? oato -03 <br />