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u ri <br /> Analysis . w <br /> r f r Region <br /> II 1 � <br /> Add 9 ('sampie s Y 721 cg <br /> woequafirsa5wice 11 <br /> Analyses Requested <br /> Facility it Z 251 A �- II II Treservatlon Codes Preservative Codes <br /> I 1 If r, H=HCI T=Thlosutfate <br /> Site Address S tri S r3 g T N=HNO3 B=NaOH <br /> S=H2SO4 O=Other <br /> Chevron PM bmS 4m%z Lead Consultant 2 '�' 0 Value reporting needed <br /> ConsultanVOffice JOB Kl�qo[t II �Z IAY��-- � El ❑Must meet lowest detection irnhs <br /> rd � � r possible for 8260 compounds <br /> Consultant Pr) Mgr a - 1 1 O r O ❑ �, ❑ <br /> Consultant Phone# )0 a4P - M Fax* [ 1(1.1 6-rA32_ 8021 k4Tt3E Confirmation <br /> ❑❑�� m m : o c ti ❑Confirm highest hit by 8260 <br /> Sampler l�� �0. 3 S ❑ ❑Confirm all hits by 8260 <br /> Service Order# ❑Non SAR z "' �' ❑Run!oxy s on highest ha <br /> Field Repeal Top Time New E x Q Run_oxy's on all tilts <br /> Point Name w 5a r Collected Feld Pt s 0 � � � � � � <br /> �-�_ Ss t3�� � II II I � Comments J Remarks <br /> ou- S-GG <br /> If ° I` a� <br /> `5 © z i III If I <br /> - �� <br /> S- -060z E. i�,d III ! �tP� <br /> _S. -!0611 S.. 91 <br /> � <br /> t II ' � Et7Q <br /> Il bca,rs��s'Kar.to�'r <br /> II <br /> Re u G b I) � Date Time Recenred by Date Time <br /> Tu Time Requested(TAT)(please arcle) C4 <br /> TD TAT 72 hour 48 hour Relinquish by If ' Date Time Received by Date T� <br /> 24 4 day 5 day <br /> Relinquished by �� �� Date Time Received b to Time <br /> Data Package Options(please circle f required) ilit: <br /> 1 �� <br /> QC Summary Type I—Full Relinquished by Commercial Carrier II i carved by $ Tane <br /> Type VI(Raw Data) ❑Coelt Delrrerable not needed UPS F, Other 4C}� <br /> MP(RWQCB) <br /> Disk Temperature Upon Receipt l-o II Ce Cu y Seals Intact? Y "No <br /> 3460 Rev 10/04/01 <br /> Lancaster Laboratories,Inc. 2425 New Holland Pike PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 <br /> Copies White and yellow should accompany samples to Lancaster Laboratories Th'e pink copy should be retained by the client <br />