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Q 885 Jarvis Drivergan Hill, CA 95037• (408) 776-9600• FAX (408) 782-6308 <br /> Ng 007301 )'819 Striker AveWe e 8 *Sacramento, CA 95834• (918) 921-9600• FAX (916) 921-0100 <br /> TOSCO <br /> ❑404 N Wtget Lane• Walnut Creek, CA 94398• (925) 988-9800•FAX (925) 988-9673 <br /> p 1455 McDowell Blvd north, Suite D • Petaluma, CA 94954* (707) 792-1865• FAX (707) 792-0342 <br /> R 1551 industrial Road •San Carlos, CA 94070- (650) 232-9600•FAX (654) 232-9612 <br /> Consultant Company 5e Cab. Tosco Engineer Ed Qat-57f-on <br /> Addmss � �+7c Site# 11/ 7 -z <br /> Clay & Coi;,610,t 4 State C/9L Zip Code 9S'67o SdeAddrm, ay Cocht� .. <br /> Telephone, f Cf_ o qb U Fax# F(/•- b Li 10 City, State <br /> U <br /> Report To ,S �. Sampler QC Data. Level D (Standard) ❑Level C ❑Level B ❑Level A Y <br /> c <br /> maround V 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water Analyses Requested ttL <br /> Time- © 2 Work Days ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> ❑ Other 0�' heti x <br /> Project Coding- <br /> Client <br /> oding Client DateMme Matrnc # of Cant Sequoia's �Q� Comments <br /> Sample LD Sampled Desc. Cont, Type Sample# 1 0 <br /> 1( Zv <br /> 2 f Z-'f,a IeWILL <br /> rr f J+ <br /> $ G <br /> 4 <br /> 5 <br /> s <br /> 7 <br /> $ 0 <br /> Q <br /> 10 n <br /> Rellnquished By, Date [-4-%vj Time• ])�3o Received Da of Time lr � <br /> t <br /> Relinquished By,, �- Time/-7 -r--r Receivedte•�" t Time, <br /> Relinquished B Date Time, Received By, Date I Time <br /> Were Samples Received 1n Good Conditions ❑ Yes ❑ No Samples on Ice? C] Yes ❑ No Method of Shipment page of <br /> To be=npteted upon receipt of report <br /> 1)Were the analyses requested on the Chain of Custody reported? ❑Yes ❑No If no,what analyses are stall needed? <br /> 2)Was the report Issued wttun the requested turnaround tlme? ❑Yes Q No if no,what was the turnaround time? <br /> Approved by Sigrmture Company' Date <br />