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Histodcal Pipeline PorffolidAnalysisRequestlChainofCustody <br /> Laricaster Labordtailes 1023 For Lancaster Laboratories use only <br /> t�c�alltyisasrience •• Acct.#: Group# /67 Sample#: &l d��d '9 7 <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: MOU NrPA N H007C- 61 Preservation Codes Preservative Codes <br /> 0 0 610 1401JB �,AL I FV 2rJ I vA H=HCI T=Thiosulfate <br /> Site Address: N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC 0 S=H2SO4 O=Other <br /> V1 U <br /> Con suItanUOffice: 11401 Alberto Way,Suite B, o s�C 9503 c `�' J value re ortin needed <br /> 1Ov: $jlZt;rlDul4`P, 47kt,A,.0; C f 4603 ° a ❑ P 3 <br /> 3 venue, cite 10, acram tU� 3/I1 to ❑ 05 Z X. <br /> Risk Assessment detection <br /> Consultant Prj.Mgr.: EFr WH IT[ U ❑ ❑ J ❑ Lou � Limits <br /> r a o C'4o� �oof <br /> ❑Chromatograms <br /> Consultant Phone#: rJ L ��'�tp'7!7 V Fax#: 510 7q 1 9 C> m o <br /> 0 0 <br /> �r � � ❑ rn o a 0 <br /> Sampler: A11�. 511.vA5 C EH L f(e : to o a <br /> Z m m C n in 0 <br /> coo o U) <br /> Field Repeat Top Time New a co <br /> o o w m = _ =m <br /> x <br /> IL IL Lu <br /> Point Name Matrix Sample .Depth Year Month Day Collected Field PtY1N 0 H m M � <br /> 1.Iq 09C)o Y y [ Comments I Remarks <br /> N $ &9/:311 10307 `f l X <br /> - W 13S Lt, l 3 <br /> B S N 5' �0 I9! +34 X <br /> +3� -°j 19 Y �! I <br /> 56- 9 �� i <br /> 56-1 N Qloo Y <br /> S +J 3 2OLY6 3 ties 1-7so— -f X X <br /> Turnaround Time Requested(TAT)[check box] Reli ?ate. lira Received by: Date Ti <br /> )(STD.TAT El 24 hour ❑ 48 hour3khAA 1 u <br /> 1:15 day El 72 hour El day Relinquished by: Date Ti Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Receive Date Time <br /> S Soil D Duplicate sample Relinquish ercial Carrier: Re ived by: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> dE Other <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS F!M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt U—IG C. pH Custody Seals Intact? No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-24 (717)656-2300 4324.01 Rev.1114105 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />