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� ,y U 0o') JUIV IJ ulIV%- - IVIUItJwI +uii, %,I-% JJVJ! k IU-) .- - -- - k --, 1�,J1� 002334 O 23 4 0 819 Striker Ave , Suite 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 ❑ 404 N Wiget Lan alnut Creek, CA 94598- (925) 988-9600 FAX (925) 988-9673 osco ❑ 1455 McDowell B orth, Suite D - Petaluma, CA 94954 - (707) 792-1865 FAX (70 -0342 ❑ 1551 Industrial Road - San Carlos, CA 94070 - (650) 232-9600 FAX (650) 232-9612 Consultant Company �� _ ,fit Protect Name 1 vs co ,,e " �O Address 3164 GV S Zy TOSCO Engineer (required) City CState Zip Code ISG 70 Telephone �(� ' - 3 0 C� FAX # r - G 3 _ Site#, City, State (� S Report To �{ Sampler• /�y ��,,�� Msn C Data vel D (standard} D Level C ❑ Level B D Level A v Re nested Turnaround 5110 Work Days Ll5 Work Days C33 Work Days ❑ Analses Drinking Water Y q a- Time ❑ 2 Work Days ❑ 1 Work Day ❑2-8 Hours ❑Waste Water QPOti`�\ �O CODE: ❑Misc ❑ Detect ❑ Eval 0 Remed W1 emol ❑Closure ❑Other Client Date/Time Matrix # of Cont Sequoia's �� QP� 0��ep \�a° ti��`� �� p4a �,' Comments Sample I D Sampled Desc Cant Type Sample #xex ��° M-O, -a s 2 Z.- S. S .t 3 2S K X A All wt/. c aa) 303 - 'flZ,p a T 3 4 d ' 3Sl a SW0 f -c4, x r 2 5 5 _ 3� 5' 1 , ?,y fr s } 6 Zr�t-H��333 7 8 9 LU 0 10 Relinquished By ate 4 2 t0 Time ;op Received By rD o y Oo Time f Relinquished By Date A Time 0:30 Received By tD e4.71610 Time /656 Relinquished By Date Time f�3,t' Received B ' Were Samples Receiv d in Good Condition? Yes ❑No Samples on Ice? Yes ❑No Method of Shipment ��LCE1l� Page of 3 � To be completed upon receipt of report 1)Were the analyses requested on the Chain of Custody reported? Yes ❑ No If no, what analyses are still needed 2) Was the report Issued w5Wn thq requested turnaround times s ❑ No If no, what was the turnaround time? Approved by Signature Company C�� Date 6 b