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U 885 Jarvis Drive • organ Hill, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 <br /> Wqn00708 U 819 Striker Ave , 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-00 <br /> U 404 N Wiget Lane •Walnu# Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 <br /> TOSCO <br /> Lt 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> U 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company Project Name <br /> Address _ - , TOSCO Engineer (required) � � 2 <br /> State tom— Zip Code <br /> Telephone 1� FAX # (9 Z �'L -y Site #, City, State <br /> Report To C; {C- Sampler s', F6 L 5 T� QC Data evel D (Standard) U Level C G Level B CJ Level A V <br /> Y <br /> TurnaroundWork Days U 5 Work Days U 3 Work Days U Drinking Water Analyses Requested <br /> Time U 2 Work Days U 1 Work Day U 2-8 Flours <br /> U Waste Water �� �ti� �ti� <br /> S1 S Q, <br /> CODE' U Misc U Detect U Eval U Remed U Demol U Closure ther .1k KP <br /> Client Date/Time Matrix # of Cont Sequoia's <br /> Sample I D Sampled Desc Cont Type Sample # ��`�� ���� �� �Q�\ �\�ti� �� Comments <br /> Est <br /> 60 <br /> CD <br /> 3 raw f 7UC: <br /> 4 0 <br /> 5 <br /> �1 <br /> 6 IL <br /> 7 <br /> 8 <br /> 9 r <br /> cq <br /> O <br /> 10lir" Illor - <br /> - t 5 i � � u) <br /> Relinquished By � Date Z8 Time �,3 Received By Date Tine u> <br /> Jay <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received Bye ate Time )3j <br /> Were Samples Received in Good Condition? U Yes U No Samples on Ice? u Yes U No Method of Shipment_ _ __ _ Page of <br /> To be c(ni npl�ted uporl receipt of I epos t -' <br /> 1) Weic, Ilse analyses requested un 1110 Cl7dln of Cuslndy repotted? U Yes U No If no, what analyses are Still needed? - <br /> 2) WLis the tepori issued within the iequebled himcliound lune`? L]Yes U No if no, what was the #utiiaround to iO <br /> AppoveLI by Sigi,atriie Company I M I e <br />