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Chevron Califomia Region Analysis RequestlChain of Custody <br /> Lancaster Laboratories fG Q „� Sample#For La aster Laborato�ieT jse only <br /> Acct # �)� t - 7� SCR# <br /> Where gwWtsascience <br /> Analyses Requested <br /> Preservation Codes Preservative Codes <br /> Facility# t - H= HCI T=Thiosulfate <br /> w • N =HNO3 B=NaOH <br /> Site Address <br /> S=H2SO4 O=Other <br /> Chevron PM fr�ir� /�_ G 1 o c�r� Lead Consultants U t"�, <br /> ❑J value reporting needed <br /> o <br /> ConsultantlOffiice 1= ❑Must meet lowest detection limits <br /> 0 o 0 possible for 8260 compounds <br /> Consultant Pry Mgr � ° <br /> '� 8021 MTBE Confirmation <br /> Consultant Phone# c� Fax# 41 fC- �iac`C�[. a - N CD <br /> CD O ❑Confirm highest hit by 8260 <br /> Sampler y E m ❑ ❑Confirm all hits by 8260 <br /> Service Order# ❑Non SAR °,� 6 ❑Run_oxy's on highest hit <br /> Field Repeat Top Time New m0 o w MT z ❑Run_oxy's on all hits <br /> Point Name Matrix iSamrile De th Year Month Da Collected Field Pt CD U m r m <br /> Comments!Remarks <br /> u <br /> 170 <br /> 1 i <br /> a <br /> 4, <br /> o cI: c �- <br /> Relinquished by �"'---1' Date Time Received by Date Time <br /> Turnaround Time Requested(TAY)(please aisle) <br /> <E25 72 hour 48 hour elinquished 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 pate Time <br /> Type VI(Raw Data) [3Coelt Deliverable not needed `f }nl <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, P12425 Lancaster,PA 17605-2425 (717)656-2300 Rev 10/04101 <br /> r nrnPs White and vellow should accompany samples to Lancas er Laboratories The pink copy should be retained by the client <br />