Laserfiche WebLink
Y-) 002990 U 819 Striker Ave , Suite 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> U 404 N Wiget Lane •Walnut Creek, CA 94598• (925) 988-9600 FAX (925) 988-9673 <br /> U 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> Trico U 1551 Industrial Road • San Carlos, CA 94070• (650) 232-9600 FAX (650) 232-9612 <br /> Project Name �� AC r��r EConsultant CompanyAddress �y� �} TOSCO Engineer (required) � <br /> City C: State � }- Zip Code_ 't� G c <br /> Telephone f�S � / 7 51 FAX # �� �� Site #, City, State ' �C r� <br /> U <br /> Re ort To �{ S-�,,J Sampler �L ;`t e' OC Data 1 evel D (Standard) U Level C U Level B U Level A <br /> p S' + <br /> C <br /> Turnaround�o Work Days U 5 Work Days U 3 Work Days U Drinking Water <br /> Analyses Requested a <br /> Time U 2 Work Days U 1 Work Day 1-12-8 Hours U Waste WaterI <br /> °�, o`Q% <br /> i <br /> CODE- U Misc U Detect U Eval WAemed U Demol U Closure �ther & 0 46\ <br /> Client Date/Time Matrix # of Cont Sequoia's �QP� ��P O��P �QP� \�,� ��G°c Comments <br /> Sample 1 D Sampled Desc Cont Type Sample <br /> 1riv�ld� LAN z3 !Y7��' P? r' r a� o <br /> cr <br /> S u 5 <br /> 31/C <br /> 4 14 e — <br /> 5 S <br /> 6 VG —Z <br /> 7 ao v <br /> $ c - IQ 2- <br /> 0 <br /> 9 <br /> 10 <br /> Date Time /�0 Received By Date Time 3 1 <br /> Relinquished By j <br /> Relinquished By Dale <br /> Time Received By Date Time <br /> Date Time <br /> Relinquished By Date <br /> Time Received 8y <br /> Page of <br /> Were Samples Received in Good Condition? U Yes U No Samples on Ice? U Yes U No Method of Shipment <br /> _ <br /> To be completed upon receipt of reportIf no, what analyses are <br /> 1)Were the analyses requested on the Chain of Custody reported? U Yes U No I1 no what was the time? <br /> 2) the report issued within the requested turnaround time? UYJ No e <br /> Signature Company <br /> Approve y — — _ -- -- _��-� _� --- <br />