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~ ❑ 685 Jarvis Drive- :""-gan Hill, CA 95037- (403) 776-96O0 •FAX (408) 762-e308 � <br /> ��. ° 007425 ❑ 619 81rikerAve., buvte 6• Sacramento, CA 95834- (915) 921-9600 - FAX(916)9211-01 G` <br /> ❑404 N.Wiget Lane + Walnut reel4, CA 94,596 , (925) 988-9600- FAX (925) 986.9673 <br /> TOSCO C) ,1465 McDowell Blvd. North,Suite D- Pstalurna, CA 94964 • (707) 792-1665- FAX (707) 792-0342 <br /> ❑1551 Indistrisl Road -San Carlos, CA 94070- (650) 232-9600 • FAX (550) 232-9612 <br /> Consultant Company: � - _ Tose Engineer: lecl:ls)sO <br /> Address: I V Al, Site#: <br /> arty: CA L\"w State: CA Zip Cede: I L/55r Site Ad dress: . <br /> Telephone-, 7 Fax#: 7107-7 _3 +$ City.state: 6,A n+ <br /> U <br /> Report To: Sampler; QC Data: Level D (Standard) ElLevel C Q Level B D Lovel A <br /> Turnaround 10 Wctk Days U 5 Worts Days D 3 Work Gays ❑ Drinking Water ,Analyses Requested a. <br /> Time; 0 2 Work Days R I Work Day Q 2-8 Flours 0 Waste Water <br /> Q Other <br /> Project C: ding: 1 ~t I oO <br /> Client Data/Mme Matrix 4 of Cunt. Sequoia's ` p <br /> Sample I.D. Sampled Dew. Cont. Type Sample# L � ` comments <br /> 4. I di <br /> � 1 Q <br /> 7. EEK <br /> i E <br /> o. <br /> Relir7quished By: Dale,; iz--17--v Time: I Ileoeived By., <br /> i7a#e; Time: <br /> t <br /> Relinquished By; Cha#e: Time: Plaaeived OV: Date: Time: <br /> r } <br /> Relinquished B Date: 'lirr Receive Dertel �k1 Time: f <br /> were Samples Received in Good Condition? ' Yes D No Samples on Ice. � as ❑ No Method of Shipment cvo-- Page_L__Of <br /> To be corn pletod upon=Q:pt of ropam <br /> 1)Were the an"as requested on the Chain of Cuawy m ported? 5 Yes !Zj No it nc,what anslyses aro still noodw <br /> 2)Wasstthe report issued within The requested turnaround tirne? Q Yes -Z)No 1fno,wtot was 1ho turnaround time? <br /> ApprovDd 14r,. -1. Oorx(a i. . slonwu Company: - Date: !Z-; Z <br />