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Chevron 1 jion Request/Chain 1 • • <br /> Lancaster Laboratories 1� 9Q, For Lt$r t_a 1r1ato+ie� se only <br /> Acct # �.�1? t a�1 Sample# SCR# <br /> Where qualrtyis a saence <br /> Analyses Requested <br /> Preservation Codes Preservative Codes <br /> Facility# �hO Z-D t I IH =HCI T=Thiosulfate <br /> Site Address `` C N =HNO3 B= NaOH <br /> S= H2SO4 0=Other <br /> Chevron PM 'eAai]�Liryt,1,c-.A _Lead Consultant <c0,IL E2 <br /> z ❑3 value reporting needed <br /> Consultant/Office c��a ❑Must meet lowest detection limits <br /> � � <br /> Consultant Pr) Mgr �f �, �{ possible for 8260 compounds <br /> j ,. L 0 - _. U ❑ <br /> �� Fax# `C o o 8021 MTBE Confinnabon <br /> Consultant Phone# a N <br /> Q o ti ❑Confirm highest hit by 8260 <br /> Sampler y ? m ; ❑ ❑Confirm all hits by 8260 <br /> Service Order# ❑Non SAR ° Z + T' C) v ❑Run_oxy's on highest hit <br /> cL + o a <br /> Field Repeat Top Time New m o o x = ❑Run_oxy s on all hits <br /> Point Name Matrix Sam le De th Year Month Day Collected Field Pt 0 1 v Ir- m r P C <br /> Comments!Remarks <br /> , 0, <br /> v <br /> 4. <br /> Relinquished by ��--� Date Time Received by Date Time <br /> Turnaround Time Requested{TAT)(please circle) —752 <br /> TD TAT 72 hour 48 hour Relinquished by Date Time Received by Date Time <br /> 24 hour 4 day 5 day <br /> Relinquished by Date Time Received by Date Time <br /> Data Package Options (please circle if required) <br /> QC Summary Type I--Full Relinquished b ial Carrier Re ei ed b ate Time <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed <br /> UPS Fed Other <br /> WIP(RWQCB) � <br /> Disk Temperature Upon Receipt C. Custody Seals intact? Yes No <br /> Lancaster Laboratories Inc 2425 New Holland Pike, PO Box 12425 Lancaster, PA 17605-2425 (717)656-2300 3460 Rev 10104101 <br /> ('nniPn White and vellow should accompany samples to Lancaster Laboratories The pink copy should be retained by the client <br />