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❑885 Jarvis Drive rgan Hill, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 <br /> N° 007299 '819 Striker Ave ,IW 8 - Sacramento, CA 95834 - (916) 921.9600• FAX (916) 921-0 <br /> ❑404 N Wiget Lane -Walnut Creek, CA 94598 • (925) 968-9600 • FAX (925) 988-9673 <br /> TOSCO ❑ 1455 McDowell Blvd North, Guile D • Petaluma, CA 94964- (70-0 792-1865 • FAX (707) 792-0342 <br /> m ❑ 1551 industrial Road * San Carlos, CA 94070 • (650) 232-9600 - FAX (650) 232-9612 <br /> aConsultant Company 0� Tosco Engineer <br /> Address o r) 7L& , Site <br /> City /ZWCh17 _, State �A Zip Code, ?5,6-2c) Site Address, G Car �-L 6 L � <br /> Telephone f = Fax N S/- 01.0 p City, State, f t$P) C �' <br /> U <br /> fleport TouS �aS,E Sampler QC Data P9 Level D (Standard) ❑Level C ❑ Level B p Level A <br /> Turnaround �;10 Work Days ❑ 5 Work Days ❑ 3 Work Days Q Drinking Water Analyses Requested d <br /> Time: a 2 Work Days ❑ f Work Day p 2-8 Hours ❑ Waste Water <br /> ❑ Other <br /> Project Coding <br /> Client <br /> tin atri Cont <br /> SaSequoia's <br /> 1e �Q� � Q�� ,�0�01 0 �0�' Comments <br /> Sample I D SaPled Cont Type P <br /> 1 �vG�r•t � G4*^ <br /> 3 3 <br /> 4 <br /> 5 <br /> 6 } <br /> U 7 <br /> 8 <br /> N <br /> N 10Cw <br /> Cr Relinquished By G.. Dale:/?'64/ Timel,0oat Received B ; Date `Gr Time 1"D'd <br /> Relinquished By Date vii Time Received BC%9AADate '4-67.m.14u <br /> � Relinquished B d B Date Time ReceiveDate Time <br /> rn Were Samples Received In Good CDnddion9 ❑ Yes ❑ No Samples on Ice? ❑ Yes Ll No Method of Shipment Page of <br /> ru <br /> U To be completed upon receipt of reporl <br /> a 1)Were the analyses requested on the Chain of Custody reported? ❑Yes Q No Ir no,what analyses are stili needed? <br /> 2)Was the report issued within The requested turnaround time? ❑Yes ❑ No It no,what was the turnaround time? <br /> Approved by Signature Company Date <br />