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LJ 000 Jdl vpb L rf lvv - MVI 9ai IF 9111, vrt�.Wv f ' %--- . I— %—1 .-- - <br /> ❑819 Striker Ave,.---Auite 8 • Sacramento, CA 95834• (516) 921-9600 • FAX (916) 921-p-9,0 <br /> 404 N. Wiget L } '• Walnut Creek, CA 94598 • (925) 988-9600 • FAX (925) 988-967 ti , <br /> TOSCO ❑ 1455 McDowell �IVd. North, Suite D • Petaluma, CA 94954 • (707) 792-1865 • FAX (797) 792-0342 <br /> . a.1 561. t4fival Road -San Carlos, CA:94070« (650) 232-9600 • FAX (650) 232-9612 <br /> Consultant 06M..-ny TIS f Ogineor} c <br /> Address, <br /> 16.7 'S7"C:Jr*k:Ca s 1 <br /> C. : SW 2i Coda: Slte'Address: <br /> G <br /> Telephonef Fax# S - Pity, State:; ..... <br /> Rtapdrt To: am ter' QC Date: ewel D (Stalnd.Vd) U.Lgvel G Level 13- c Leel A ,� <br /> c <br /> Tumaroand 10 Work Days € . ; Werk. rs ❑ 3 WorkE3a ❑ �]rtnEcirtg Water Adalyse5 Requested a <br /> Time: J 2 Work 11&Y. ❑ 1 Mork Day. ❑ i�-P hlotirs ❑ Wast&Water <br /> - Other <br /> Project Coding.- <br /> Client <br /> odin ..Client DatefTime Matrix #of Cont. Sequoia's <br /> Sample I.D. Sampled Desc. Cont. Type Sample # Comments <br /> 2. )AW- 15 S1 I , -,�Pitts <br /> 3, _ 13. l (9101��� no ti c <br /> IF <br /> A <br /> 4 E. o 2 A <br /> 5. 1 AIM lay 0 <br /> 6. �kw- 14- ga. ,a <br /> 5717-6 a 03 <br /> 8. Mw - 1:5- 1 <br /> 9. !kw- 5 <br /> 10. <br /> Relinquished By: Date: z�l Time: 5 Received B Date:s Time: <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> Were Samples Received in Good Condition? ❑ Yes ❑ No Samples on Ice? ❑ Yes ❑ No Method of Shipment Page of <br /> To be completed upon receipt of report: <br /> 1 I Were the analyses requested on the Chain of Custody reported? ❑Yes (a No if no,what analyses are still needed? <br /> 2}Woo the report issued within the requested turnaround time? ❑Yes ❑No If no,what was the turnaround time? <br /> Approved by: Signature: Company: Date: <br />