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U 885 Jarvis Drive • Morgan Hitt, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 <br /> ��(l 0 01588 8i9 Striker Ave., Q 8• Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-01U• <br /> *404 N.Wiget Lan�alnut Creek, CA 94598 • (925) 988-9600d7AX 2918fi5 FAX (707} 792-0342 <br /> 88-9673 <br /> U 1455 McDowell Blvd. North, Suite D • Petaluma, CA 94954 ( ) <br /> Osco U 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Project Name:' L,� Oq ^ S <br /> Consultant Company: �� Qle DIJ _� <br /> -- _ ti TOSCO Engineer (required) SM <br /> Address:: ���� ��� p�_1 <br /> City: State: Zip Code: .- <br /> Site #, City, State: T[o 9 ��_ ❑ Levet A <br /> ' <br /> Telephone: FAX #: _ 3�J� U <br /> QC Data: U Level D (standard) Level C U Level <br /> B <br /> Report 70: � Sampler: c <br /> Turnaround 10 Work Days U 5 Work Days U3 Work Days U Drinking Water Analyses Requested a- <br /> U 1 Work Day U 2-8 Hours U Waste Water <br /> Time: U 2 Work Days v�� oaf <br /> CODE: U Misc. U Detect. U Eval. U Remed. U Demol. U Closure <br /> U Other �� � %�``S <br /> Date/Time Matrix # of Cont. Sequoia's ��� �� �,� �p�,o\,�������,������v� Comments ' <br /> Client 1 <br /> Sample 1.D. Sampled Desc. Cont. Type Sample # <br /> ti S a <br /> L) <br /> o <br /> 3.0-�°r <br /> 4. <br /> 5. <br /> 6. <br /> 7. <br /> 8. 0 <br /> Cr <br /> 9. cn <br /> 10. ' <br /> Date: 7ime:l�1. <br /> Date �,�. �U Time:Y71 Received Received By: <br /> Relinquished By: rc GG1Cr�a=x'` �� — —�- Time: 3 <br /> Data: Time: <br /> Received By: Date: <br /> Relinquished By: Date: Time: <br /> Date: Time: Received By: <br /> Relinquished BY: Page,-of 3.. <br /> Were Samptes Received in Good Condition? s U Na_.—Samples on Ice? s Cl No Method of Shipment- - <br /> To be completed upon receipt of report: <br /> 1 Were the analyses requested on ilie Chain of Custody reported? U Yes es o No It not, what <br /> the tirnaroundltime? <br /> needed?-_� --�. ---—-- <br /> time. . F <br /> 2� Was the report issue tun ie requested turnarUultd Date.-.. .... <br /> Si��Eature� .��. .. ._. .... Company:. _.-.. /T - .. <br />