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001295 L1885 Jarvis Drive " Mol <br /> Mor Hrll, CA 95037 - (408) 776-9600 - FAX (408) 782-6308 <br /> 819 Striker Ave . Sutt�Sacmmento, CA 95834 - (916) 921-9600 FAX (916) 921-0100 <br /> / U 404 N Wiget Lane-Walnut Creek, CA 94598 - (925) 988-9600 FAX (925) 988-9673 <br /> 6CAL <br /> loom U U 1455 McDowell Blvd North, Suite D - Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792 0342 <br /> U 1551 Industrial Road - San Carlos, CA 94070 - (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company Gfiev- ZPro)ect Name C-4 ` <br /> Address _ 7Y7 7 S!�L e J TOSCO Engineer (required) <br /> City � 1�h State (fA Zip Code <br /> Telephone qZ5-5"S1_ 7555 X I q 1 FAX # c7j:5 S/.. 78 Site #, City, State 0i8? <br /> Report To ' � Sampler jet OC Data xLevel D (Standard) U Level C U Level B U Level A U <br /> Y <br /> Turnaround U 10 Work Days 5 Work Days ❑3 Work Days ❑Drinking Water Analyses Requested <br /> TimeU 2 Work Days U 1 Work Day U 2-8 Hours p Waste Water �� tib e�°n, <br /> CODE: U Misc U Detect U EvalRemed ❑Demoi L)Closure ❑Other °\F <br /> Client Date/Time Matrix # of Cont Sequoia's Q�� �P� `P QQ°° o�� °o�``�� <br /> Sample I D Sampled Desc Cont Type Sample # �Q�� X60- ���� 1Q�� °��` ��0`�G Comments <br /> x X' ? R <br /> cc <br /> 0 <br /> �P 1- l�� oil X rn <br /> 4 <br /> 5 L AA'' <br /> - 2-0 <br /> } <br /> T6 =z- 6D cl o <br /> 112 <br /> 8 <br /> 9 <br /> lotm <br /> 10 <br /> a- <br /> a� <br /> Relinquished By Date �' d/ Time �� Received Bmf,( e d j 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? U Yes ©No Samples on Ice? U Yes ❑ No Method of Shipment Pane _ of <br /> To be complexed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? U Yes U No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? U Yes U No 11 no, what was the turnaround time? <br /> Appioved by Signature Company pato- <br />