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* HIII CA 95037. 408 776 96M*FAX JJ40$ 782-634$ <br /> � 010170 ❑$85 Jannis Drive Morgan , ( ) 4 1 <br /> 10819 Stnker&B,5ulte a•Sacramento,CA 95034■(910)921 96DO*FAX(916)921-0190 <br /> S C ❑404 N Wigot Lane,,walnut Creek,CA 94598*(925)988-9600 r FAX(925)988-9873 <br /> L 11455 McDowell Blvd Horth,Suite D•Petaluma,CA 94954-(707)792-1865*FAX(707)792-0042 <br /> ©1551 lncfuslrial Fload•San Carlos,CA 84010*(t354)232-9600*FAX(650)232-8612 <br /> Consulhint Cornpan 4. Tosoo Engineer <br /> Pa 15j�MI <br /> 91 sate a_ <br /> Andress G ►^. C. 0- •_ 1`f � I -- <br /> City Vf1 M t Sfate Zip Gude ! Site Addre+ss C! i�i l'Tf <br /> Telephone1707) Fax# _3jx Email 60 Cay,state G9 61{!�f 6/4 <br /> 4 ` / Sant ler f 1:5 Cie Dala Level D(St�3ndard) ❑Level C [-;Levet B [j Level A °1 <br /> 1leportTo 1 V to P �78� - v <br /> Turnaround jt1Q Work Days t�5 Work Days LJ9 Work Days G Winking Water Analyses Requested _ <br /> Time ❑ 2 Wotk Qays ❑ t Worts aay U2-81-lours Ll O hoe Waterb ttr a� � VP <br /> 0 � ti <br /> ' <br /> Project <br /> Client Date(Tifrle Matrix 9 of Cont Sequoia's .r commants <br /> Sample t D Barn led Desc Cont Type Sumttio r4 Gk _ — <br /> 2 - Tb °old_wkky 3 VV - — _ <br /> 3 - _ _ <br /> - - <br /> 4 - — — - - ri <br /> 6 -- - <br /> 7 - <br /> 10 <br /> I�ehnqufshetl By <br /> to Time 6V ReceivedTta <br /> Date Time received 8 Date Time <br /> Re4nitufshesf lay _ - - <br /> l3elrn uishCd B Dula Time Ftecerved By Date. Time <br /> Worts Samples Received In Good Condition L)Yes E]No Samples on Ice? ❑Yes p No Melhod of ShlpMenl_ _Y Page of <br /> To be completed upon receipt of report <br /> 1)Were the analyses requested on the Cham of Custody reported? Lees ❑No if no.what 8nalyses are shit needed? _ <br /> Lv <br /> Wasthe repariissued Withln tine requested turnaround time? [ Yes ❑No 11 no,what was lite turnaround time?dby�D,�.. A t;nmpar>1r 62 2 _ i?aie <br /> -5-0 3 <br />