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NQ 010141 ❑885 Jams Drive a On HI I!,CA 85037 a(408)776 960■FAX 1408)782-6308 . <br /> Wei 9 Stn ke r Ave,Suit98■Sacra rrrento,CA 95834•(916)921-9600*FAX(916)921-0100 <br /> ❑4044 N Wiget Lane■Walnut Creek,CA 94598 1(925)988.9640 a FAX(925)988-9073 <br /> TOSCO ❑ 1455 McDowell Blvd North,Suite 0 a Petaluma,CA 94954,(707)7U2-16659 FAX(747)792-0342 <br /> ❑1551 Industrial Road a San Carlos,CA 94070 a(650)232-0600*FAX(C60)232-9612 <br /> Consultant Company — 4 Tosco Engineer <br /> Address. _ t cYtC S 1W site : ? <br /> coy. L r tato- CA zip code qQ�7a Site Address, �1 <br /> Taropitane {� r- a� Fax alb 6rnarl f �' ucr u city stalo <br /> Report Tosampler ,,, Or,Dela: f�Level G(Standard) n Levet G [_]Leval B L)Level A <br /> Turnaround Fgi Work Days d 5 Work Bays L13 Work Days ❑Driniong Water �}� _ Analyars Requested c <br /> Time: ❑ 2 Work Days L)1 Work Day ❑2.8 hours C]Waste Water Kr„� <br /> F1 Other �o <br /> Project Coding &b <br /> Cilent Ratefffine Matrix #of Cont Sequoias . �, ' <br /> Comments <br /> Sample 10 l! <br /> Sampled Desc Coat Type Sample <br /> _ +� b} <br /> 4 _ <br /> 10L8 - <br /> $ _ o <br /> — 3 <br /> _ Date'? O TimQ fY� Receive Cato- Tlrnol �� ' <br /> RehriquTshed Ry — __ — <br /> Relmquished By Dato Time Recenred By. Date Trmo <br /> Rehm ursited 8 _ Date Titna Roccnrcd By. Date Time _ <br /> Were Samples Received in Good Condition L1Yos ❑No Samples on loe? []Yes (]No Method a1 Shipment _ Page of � <br /> To be completed upon receipt of report <br /> 1)Were The analysas requesled on the Chain of Custody reported? []Yes []No It no,what analyses are still needed? <br /> 2)Was The report Issued wrlhln the requested turnaround time? (JYcrs ❑NP If 0io,what was the turnaround time? <br /> Approved by _ Signature _Company Dato <br />