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L_[ Ca,?%idrvi; unvu - morgan rim, %.A wou3t • t4uo9 if o-boovu - rw% k4VOI fO4-*;5U F <br /> ° 007661, Q a't9 Striker Ave., Suite$ + Sacramento, CA 95834 - (916) 921-9800 - PAY, X916) 921-0100 <br /> W� N.Wiget Lane • %Vainut Creek, CA 94:598 - (925) 988-9600 - FAY,(928) 988-9673 <br /> RS�0 0 1455 McDowell Blvd. forth, Suite l) • Petaluma, CA 94954 • (707-) 792'1&65 - FAX (747) 792-0342 <br /> 1661 Industrial Road - San Carlos, CA 94070 - (650) 232-9840 -FAX (660) 2321-9$12 <br /> Consultant Company, y_ �" J } Tosco Engineer, �._j ell <br /> Address; hecto 4 $rte 9: 11 r S` D 6 64 6d <br /> State: e-4 Z1p Coda: Site Address: <br /> Telephone:--�o 4 S%)- 3_5-f F'ax#: -7-e9- -top a 1 City, State: <br /> Report To: 7�- vc� r Sampler: r ,,,r ► ; QC [Data'. Leel D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround -N 10 Work Days :1 5 Worst Days ❑ 3 Work Days :D Drinking Water �, Analyses Reques#ed CL <br /> Time_ G 2 Work Days ❑ 1 Work Day ❑ 2-8 Hours 7 Waste Water <br /> Project Coding: �� Q b. <br /> Client DateMme Matrix 0 of Cont. Sequoia's ;. o �� <br /> Sample LID, Sampled Desc. Cont. Type Sample # comments <br /> L.JAW-16- I 1 �#tib `{c7� ( i <br /> 3. <br /> 4, - i t to <br /> 5. W- a <br /> 0 <br /> lJ, <br /> 'a <br /> 9. t. <br /> c� <br /> 10. <br /> ti <br /> Relinquished By: Dater r lime: tle- Received B : Date: Time:jm <br /> Relinquished By.- Date: "rime: Rooelvod B ; Date Time: (cr, <br /> Rellnquisr ed By,, Date: _ , Tirne, ReceiveS : Date; l Tirne:C?i <br /> were S,ampCes Received in-Good Condition? ❑ Yes :1 No Samples on Ioe? ❑ Yes (a No Method of Shipment Page of <br /> To bo completed upon rocolpt of report <br /> 1)Were this analyses raguasted on the Chsin of Custody reported? Zj Yes ❑ No If no,wha:analyses arg still needed? <br /> 2) Hos the ropo�Issued wldl In tho requostod tummund time? Z)Yes ❑ No If no,what was the G lmarownd time? <br /> Approved by:_ 8lgnature, Company: Date: <br />