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❑ 885 Jarvis Drive - Morgan Hill, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 <br /> 1VT 007217 �..404 <br /> 19 Striker Ave , 8 • Sacramento, CA 95834 - (916) 921-9600 - FAX (916) 921-01. <br /> N Wlget Lane alnut Creek, CA 94598 - (925) 988-9600 - FAX (925) 988-9673 <br /> TOSCO ❑ 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 ��ec e ' r �• .,;�G .�t Tosco Engineer t- <br /> Address ;bt 1 kitr � ca Srz, ic6 Site # <br /> City &,W itr, coeoj,.'i State C4q Zip Code q54,11 Site Address <br /> Telephone Fax# (y,�, 50 I(I,i3L City, State , , ,p� KA 2 <br /> Report To CL,, l OAC&,S Sampler 1) 11 he e' QC Data p Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround a 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water Analyses Requested v CL <br /> Time. ❑ 2 Work Days ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> ® Other ��Q'�' �y> 1 %T <br /> Project <br /> co coa; <br /> Project Coding <br /> Client DateRme Matrix # of Cont Sequoia's �Q�� Q�q\ �� ��°o `�O Comments <br /> Sample I D Sampled Desc Cont Type Sample # o <br /> 2 58-1 C 15 ' ca <br /> 3 56-ie Z0 k t, <br /> Cr <br /> N <br /> 5 SB-1 C Z'S x Y* o <br /> 6 <br /> 7 SJ-/e 35 <br /> 8 so-/ e380 <br /> a <br /> a <br /> 9 56-1e46 <br /> rn <br /> 10 5i-}C 51S <br /> 46m <br /> Relinquished By JIA Time/616DateZ !'1 �/ me�G�� Received B `7 Date[Z �t Time L <br /> Relinquished By Date Time Received By Date Time <br /> Relln uished By Date Time I 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)Were the analyses requested on the Chain of Custody reported? ❑Yes ❑ No If no,what analyses are still needed? <br /> 2)Was the report issued within the requested turnaround time? p Yes ❑ No If no,what was the turnaround time? <br /> Approved by Signature Company Date <br />