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002336 O�� C U 885 Jarvis Drive a Morgan Hill, CA 95037 - (408) 776-9600 a FAX (outs) 782-bJU8 U ❑819 Striker Ave , S Sacramento, CA 95834 (916) 921-9600 FAX (916) 921-010 ❑ 404 N Wiget Lanellnut Creek, CA 94598- (925) 988-9600 FAX (925) 988-9673 IF 0sco ❑ 1455 McDowell Blvd North, Suite D - Petaluma, CA 94954 - (707) 792-1865 FAX (707) 792-0342 ❑ 1551 Industrial Road - San Carlos, CA 94070- (650) 232-9600 FAX (650) 232-9612 Consultant Company G f , 0% 4 Project Name os Lo �F�az '- Address3 �►� �� k { Zy0 TOSCO Engineer(required) C' City 1a State CA Zip Code L(0 ? Telephone 1116 � 31 -- 1300 FAX # �C _ 3 _ 3 Site #, City, State S c ( a Report To Sampler Aill e.,-e /H e--1 �,�yy QC Data evel D (standard) ❑ Level C ❑ Level B ❑ Level A v Y Tumaround ❑ 10 Work Days ❑5 Work Days ❑3 Work Days ❑Drinking Water Analyses Requested a Time, ❑ 2 Work Days Q-1Work Day ❑2-8 Hours ❑Waste Water CODE: ❑Misc ❑Detect O Eva! ❑ Remed ❑Demol ❑Closure ❑Other Client Date/Time Matrix # of Cont Sequoia's �` �QP� \P " �P� ��,° Vo��` Sample I D Sampled Desc Cont Type Sample # Comments 1 3 S r `f lz4 oa f Szy S arc i1 K r'ea 0 2 oS 3 4 0} 5 6 7 8 9 0 n 10 C Relinquished By ate Z 00 Time p !cg> Received By ate q Z O[� Time 0 dD a� Relinquished By Date Time OS 3V Received By Date zl Time Z630 Relinquished By Datef(Z 7 DU Time /S Received By Date Zy Time 1/ S c-� I Were Samples Receive Good ondition? Yes ❑No Samples on Ice? Pes L)No Method of Shipment J� Page 2 of 3 To be completed upon receipt of report 1)Were the analyses requested on the Chain of Custody reported? 'es O No If no, what analyses are still needed? 2)Was the report issued wr n the requested turnaround time? \Yes ❑ N If no, what was the turnaround time? Approved by Cry 1-.0.r _ Signature Company _ L��— Date