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❑ 680 Chesapeake Drive • Redwood City, CA 94063 • (415) 364-9600 ❑ 18939 120th Ave., N.E., Suite 101 • Bothell, WA 98011 • (20.481-9200 " <br />® ❑ 819 Striker Ave., Suite 8 • Sacramento, CA 95834 • (916) 921-9600 ❑ East 11115 Montgomery, Suite B • Spokane, WA 99206 • (509) 924-9200 <br />❑ 1900 Bates Ave., Suite LM • Concord, CA 945209(510)686-9600 ❑ 15055 S.W. Sequoia Pkwy, Suite 110 • Portland, OR 97222-(503)624-9800 <br />'Company N- <br />CODE:'QC <br />• • - - <br />City: <br />Release #: <br />Telephone: NO 3 i = <br />Data: XLevel D (standard) U Level C U Level B U Level A <br />Turnaround UjoWorkDays U5WorkDays U3WorkDays L11 Drinking Water <br />LJ Waste Water <br />■ misc. Detect. Ll Eval. ■ Remed. LJI Demol. ■ Closure ■, Other <br />Client Date/Time Laboratory <br />Sample I.D. Sampled SamDie # <br />FU 1111 UM :N` 100 <br />11`11 ANNE 0 Mr. MN <br />• ! ■/�0 <br />Relinquished By:jff <br />dM 9M. OFIfflf-akillf - <br />Were Samples Received in Good Condition? 4yes U No Samples on ice? Yes U No <br />uested <br />s <br />Comments <br />Lei <br />Cf� ate: a,/97 Time: <br />of Shipment. -e 11,01 t c;% Page ca? of <br />To be completed 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 If no, what was the turnaround time? <br />Approved by: __. _ _ . _ -_ Signature: _ __ _ __ Company: <br />__ Date: <br />