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• <br /> u ots� Jarvis urive • lan Hill, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 � <br /> 000678 ❑ 819 Striker Ave , Sure 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> 0sco ❑ 404 N Wiget Lane -Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 <br /> ❑ 1455 McDowell Blvd North, Suite D - Petaluma, CA 94954 - (707) 792-1865 FAX (707) 792-0342 <br /> ❑ 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company�� �— <br /> !2✓. Project Name S Co 5 <br /> Address G <br /> � TOSCO Engineer (required) <br /> City J L � State Zip Code C�l S <br /> Telephone I �a <br /> Re ort To # 9! G 3l - !3( Site #, City, State <br /> p S � �L Sampler 5, .7— QC Data Level D (Standard) ❑ Level C © Level B ❑ Level A V <br /> TurnaroundWork Days U 5 Work Days ❑3 Work Das ❑ Drinking Water -" <br /> Time y J Analyses Requested � <br /> ❑ 2 Work Days U 1 Work Day ❑2-8 Hours it <br /> ❑Waste Water �� �,� <br /> CODE: 0 Misc ❑ Detect ElEval Remed CJDemol C3Closure U Other ,h�oa�aS\ of �, h����5� <br /> Client Date/Time Matrix # of Cont Sequoia's Qaa° P 1 P�� <br /> Sample I D Sampled Desc Cant Type Sample # �Q�� ��`v�� ����`4 �Q�` �o\a��e. ���`� Cmeets <br /> A-r l T <br /> 2 42Sa6- <br /> 3 <br /> 4 <br /> v5L 6-y/ t 7 on <br /> 5 <br /> 6 <br /> 7 <br /> 8 ~S +o <br /> 9 <br /> 10 <br /> Q <br /> D <br /> Relinquished By ate /� �i Time Received ByDate Time <br /> t�t1'� <br /> ~ Relinquished By Date Time Received By Date � <br /> Time <br /> �Quished By Date Time Received By Date Ttme <br /> �ece,ved in Good Condition? ❑Yes ❑ No Samples on Ice? 0 Yes ❑ No Method of Shipment Pae of <br /> ^on receipt of report 9 <br /> uses requested on the Chain of Custody reported? ❑Yes ❑ No If no, what analyses are still needed? <br /> 'ued within the requested turnaround time? ❑Yes ❑ No If no, what was the turnaround time? <br /> Signature Company Date <br />