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• law=,;Lot <br /> • • iw. aam 1 • • <br /> +Laxaster LabOraV es For <br /> 0L � 11" as o-nly <br /> Kfwrylsasoen ' DZTbrVQAcd Sample =4.04 SCR# <br /> Analyses Requested <br /> 729-4275 G--R#3BW5 <br /> Faci ty# Matrix Preservation Codes Preservative Codes <br /> Site Address 2905 W BNJAM N HO T, H=HCl T=Thiosulfate <br /> F <br /> Chevron PM RC SECORGM N=HNO3 8=NaOH <br /> Lead Consultant S=H2SO4 O=Other <br /> nc , terra Court, Suite u in, y r-ti <br /> Consultant/Office ww _ ❑ p ❑J value reporting needed <br /> Manna r Ins eanna grinc com R 9 •9 ❑Must meet lowest detection limits <br /> Consultant Prl Mgr , z <br /> possible for 8260 compounds <br /> []Non 5AR a 0 <br /> Consultant Phone#925-551-7555 Fax# 925-551-7&% a 8021 MTBE Confirmation <br /> Sampler ❑ $ ❑Confirm highest hit by 8260 <br /> 13 <br /> Service Order# .. L ©Confirm all hila by 8260 <br /> _ _ <br /> Det9 Time ❑ $ $ [3 Run oxy s on highest hit <br /> Sample Identlficatlon Collected COI ected C7 C) O H m ❑Run_oxy s on all hits <br /> Comments 1 Remarks <br /> +___ I(P XA___ <br /> w— L <br /> 14W t4- <br /> ILA <br /> " � X <br /> W _a <br /> kAkl- <br /> w� <br /> T nd Time Requested(TAT)(please duds) elinqu ed %D9 Time v Date Time <br /> S D TAT 72 hour 48 hour <br /> 24 ur 4 day 5 day Time ived by D to Time <br /> Data Package Options(please circle if required) Reunqui9ned Date Time Received by Date Time <br /> QC Summary Type l—Full /Y / Ai<,l'i kI SG <br /> Type VI(Raw Data) ❑Coolt Deliverable not needed Relinquished by Commercial Carrier Rete Date Time <br /> WIP(RWQC8) UPS FedEx V Other I&Disk Temperature Upon Receipt C° <br /> - _ Custody Seals Intact? es No <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,PO Box 12425,Lancaster.PA 17605.2425 (717)6W2300 3460 Rev 7130101 <br /> Copies White and yellow should accompany samples to Lancaster Laboratories The pink copy should be retained by the client <br />