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U 885 Jarvis Drivorgan Hili, CA 96037 - (408) 776.9600- FAX (408) 782-6308 N° 0 0 7 2 9 8 1819 Striker Av ite 8 - Sacramento,CA 95834 a (916) 921-9600 - FAX (916) 92100 ❑ 404 N Wiget Lane - Walnut Creek, CA 94598 - (925) 988-9800 - FAX (925) 988-9673 TOSCO (3 1465 McDowell Blvd North, Suite D - Petaluma, CA 94964 - (707) 792-1665 - FAX (707) 792-0342 ❑ 1551 Industrial Road - San Carlos, CA 94070 • (660) 232-9800• FAX (650) 232-9612 In in Fd nsultant Company Sec p v Tosco Engineer � 2 S a�K a dress• �!C Site H y:-moi L ►v CSG OUA State• Ztp Code° �S6?� Stte Address tv o Cavrn.�- CLv Telephone: �04� Fax rt- 7-61_ G47 o City, State for r, Report Ta v f rjem �osX Sampler �o QC Data Level D (Standard) ❑ Level C ❑ Level B ❑ l evel A c Turnaround 10 Work Days ❑ 5 Wark Days ❑ 3 Work Days Q Drinking Water Analyses Requested a. Tlrrre• ❑ 2 Work Days 0 1 Work Day ❑ 2-8 Hours 0 Waste Water ihsr ro\ Project Coding. Client DatefTme Matrix 11 of Cont Sequotas SQA , Comments Sample i D Sampled Desc Cont Type Sample 9 1 �- 2 Y 3 KO f 2�?��1 X120 VO4 1-?teat ) Y 4 �`f' rw�A 'W 3 VOA 5 rn lw 3 ,, p h Zo 3 Vo,4 c V 0 4 U 7• cc of Q 8 O a Z) 9 N 10, ar IL Relinquished Bye- Date' ?'�'�'( TEmedr' Received Date/Y,1-4/ TiinwelfZj } A001 ,/� A Relinquished B r'` - Date4L TimeY�� Received ate (4 01 Time .� I Relinquished B • Date Time* I Received By Date Time m � Were Samples Received in Good Condition9 ❑ Yes q No Samples on Ice? ❑ Yes ❑ No Method of Shipment Page of U To be completed upon receipt of report Ld q 1)Were the analyses requested on the Chain of Custody reported? Q Yes ❑ No If no,what analyses are still.needed? 2)Was the report Issued within the requested tumaround time? ❑Yes L)No if no,what was the turnaround time? Approved by Signature I Company rate