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Na p 885 Jams Drive-Morgan Hill,CA 95037-(408)776 9600-FAX(408)782-6308 <br /> 819 SBiker Ave,Suite 8-Sacramento,CA 95834-(916)9219600-FAX(916)921.0100 <br /> 110 p 404 N Wiget Lane-Walnut Creek,CA 94598-(925)988 9600-FAX(92q 988 9673 <br /> TOSCO p1455 McDowell Blvd,Not,Suite D-Petaluma,CA 94954-(7O1 7921865-FAX(707)792 0342 <br /> Q 1551 Industrial Road-San Carlos,CA 94070 (650)232 9600-FAX(650)232-9612 <br /> Consultant Company, c Tosco Engineer <br /> Address. Site#' <br /> Crt State. Zip Code Site Address t �, <br /> Telephone: _ -�,� Fax# gl�- �r•0 50 City,Slate <br /> ReportT Sampl . 2& QC Data p Level D(Standard) p Level C p Level B a Level A y <br /> G <br /> Turnaround,� low-ark Days 0 5 Work Days 0 3 Work Days C Drinking Water Analyses Requested d <br /> Time: p 2 Work Days a 1 Work Day a 2-9 Hours 0 Waste Water a a0 <br /> Q Other ����'�pNb� <br /> Project Coding <br /> Client Date/Time Matrix #of Cont. Sequota's �� Quo � °o Comments <br /> Sample I D Sampled Dese Cont. Type Sample# a <br /> 1 XI r�rP �j <br /> 2. zt f¢12Grte1 � <br /> o <br /> 3 Cr <br /> w <br /> 5 0 <br /> 6 } <br /> 7 <br /> ro <br /> 4' <br /> 7 <br /> 9or <br /> N <br /> 1D Irl d <br /> m <br /> Relinquished BY Date 9-oA Time,/0 Received B Date t Q Time- 1` <br /> Relinquished By Date, Time: Received By:- Date: Time, <br /> Relinquished By- Date' Time I Received By: Date. Time. <br /> Were Samples Received in Good Conddion? 0 Yes Q No Samples on Ice? p Yes o No Mebd of Shipment Page____of <br /> To be completed upon receipt of report <br /> 1)dere the analyses requested on The Chain of Custody reported? a Yes o No If no,what arralkses are shit needed? <br /> 2)Was the repot issued wANn the requested lurrtaraundhme? U Yes p No 11 no,whatwas the lumaround lime? <br /> Approved by; %nalure COMM Date <br />