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❑ 885 Jarvis Drive 4organ Hili, CA 95037 • (408) 776-9600 • FAX (40U) 782-63UU <br /> . �,� ()0, 1 -2 1 p 819 Striker Ave jWe 8 • Sacramento, CA 95834 - (916) 921-9600 - FAX (916) 921 <br /> L]404 N Wiget Lane • Walnut Creek CA 94598. 925) 988-9600• FAX (925) 988-967 <br /> jj1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 - (707) 792-1865 • FAX (707) 792-0342 <br /> TOSGO ❑ 1551 Industrial Road • San Carlos, CA 94070 - (650) 232-9600 • FAX (650) 232-9612 <br /> Consultant Corn larty ~� ` - <br /> thy, � Tosco Engineer L <br /> - <br /> Address � ,��� �� ��, Site # <br /> G€ty i� State ' Zip Code �""� � Site Address L/707 ^c vG <br /> >} <br /> Telephone Fax 4t _ -� f City. State eC- {'a n U <br /> Report To <br /> CSC Data ❑ Level D (Standard) ❑Level C p Level B ❑ Level A <br /> c <br /> Turnaround j 10 Work Days 5 Work Oayx _j 3 Mork DgY6 _j Drinking WatLr An,,lys: �, Requested a <br /> T#rtle_ _I 2 Work Days :.f t Work Gray .di 2 8 HOUrs J Wade watar <br /> C7tift'r <br /> P€olect Coding _ <br /> ~~� <br /> Client � tE'�4ri1Q Matrix C3� Cof <br /> Sample t D — S'lempted Desc Cont Type San�l�t id <br /> LS <br /> _ o <br /> — _ _ <br /> —— _ <br /> _ _ __ _ _ !_—__I _�___ _ _ <br /> Cn <br /> 4 <br /> 5 ,,jOLER ta,M`t._,. 1)Y SEALS 1N xCT - <br /> _� _ <br /> 9 <br /> 10 <br /> Date l ( Tiime ' Ret e <br /> Relinquished By t .- -�.�--. -�-- ed l <br /> Relinquished By Date Time - _ --------q /—' _ _ _ _ 3 io _t j� e <br /> Relinquished By Date Time Received By Date Time <br /> Were Samples Received in Good Condition? ❑ Yes ❑ No Samples on Ice? p Yes ❑ No Method of Shipment Page of <br /> To be completed upon receipt of report <br /> 1)Were the analyses requested on the Chain of Custody reported? ❑Yes ❑ No If no,what analyses are still needed) <br /> 2)Was the report issued within the requested turnaround time? I]Yes ❑No if no,what was the turnaround time'? <br /> Approved by Signature Company Date <br />