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t� 002337 <br /> 3 3 7 U 85 Jarvis Drive • Morgdn Htii, GA 9503% • (408) 776-'9600 • FAX (4U8) 782-b3U8 <br /> V Fi 1 19 Striker Ave , S 8• Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-010 <br /> U 404 N Wiget Lan alnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 is <br /> rosco U 1455 McDowell Blv 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 6- �� let, ., v Project Name >Lc) c d7 1 <br /> Address ?,j SKL Z yp TOSCO Engineer (required) <br /> ,e2 &. <br /> City C�� ate C,C� Zip Code 154 7t7 <br /> Telephone ( 0 4 FAX # �/� _ G 3� Site #, City, State (� �' f � L <br /> Report To Sampler , a~� =QCData [ vel D (Standard) U Level C ❑ Level B 0 level A U <br /> Y <br /> Turnaround U 10 Work Days U 5 Work Days U 3 Work Days El Drinking Water Analyses Requested 9 <br /> Time U 2 Work Days GVfWork Day U 2-8 Hours D , ��� � it <br /> Waste Water <br /> CODE: U Misc U Detect U Eval U Remed 0 Dernol ElClosure U Other h�� �\ ��, 5 ,11 <br /> ��`` <br /> Sample f D ClientDSam P led Descx Cont TyR# ofone SamuP �pe # Q��QP�o�� \��� ��PrP 18 <br /> � � �O`�� Vo�\`�a� Comments <br /> �Q J <br /> 2 s z ( - d it <br /> s eg <br /> 3Aq_ 8 s- s H it -0 X X X U) <br /> 4 <br /> 5 <br /> 6 <br /> 7 '.�,... <br /> 8 <br /> r <br /> 9 _ _ <br /> 41 <br /> 1� r Cr <br /> ill <br /> (n <br /> Relinquished By ;(� µ Date YZ� ap i /a `f'S Received By ate Time rd 5t r <br /> Relinquished By _ Date .ZT_ Timej `r✓`j Received By, ate Time l 4, <br /> Relinquished By Date Time 1 Received By Date Time <br /> Were Samples Received in Good Condition? ❑Yes U No Samples on ice? U Yes t7 No Method of Shipment �— Page_ -of <br /> To be completed upon receipt of report <br /> 1)Wet the analyses requested on the Chaim of Custody rvpoi ted'� d1Yes U No It no, what analyses doe still needed? <br /> 2) Was the report issued within the requested turnaround I me? Yes U No It no, what was the turnaround time? <br /> Approved by ---- / �•�- - Signaliue - -- - - - Company _ Gr�"` y i7atr � � <br />