Laserfiche WebLink
Histodcol Pipeline ' • 1 1AnolysisRequestlChoinofCustody <br /> Lancaster 1234 For Lancaster rLab�o}ratories use only ? (� [ - r <br /> VVheregtA*isascience. Acct.#: 1 Group# IoB o Sample#: J J 1 �J 00 1 1 <br /> Please print 1033�)" �7"� r �G� Analyses Requested SCR#: <br /> Site/Global ID: D,.A ,C Preservation Codes Preservative Codes <br /> A H=HCl T=Thiosulfate <br /> Site Address: a N= HNO3 B=NaOH <br /> _ <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC S= H2SO4 O=Other <br /> y U <br /> Consultant/Offce: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 �_ 0 a ©J value reporting needed <br /> C9 a HPP Risk Assessment Detection <br /> 3800 Watt Avenue,Suite 2101 Sacramento,CA 95821 0 E] '� z Limits <br /> 0El Lu <br /> Consultant Prj.Mgr.: h • ❑ ❑ ®J o ❑Chromatograms <br /> / r Iq ° N C, �l of X <br /> Consultant Phone#: L }J Fax#:`Sp —7� ° ° �_ co o U <br /> A <br /> / .� ❑ �" o0 0 0 2 <br /> Sampler: A• / �• I y co N , <br /> ° Z oo °O m o <br /> a o o m <br /> Field Repeat Top Time New o LU m i = = aw <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN c7 U H m a ~ <br /> 0_11-1 Zyj Comments!Remarks <br /> Sia—L f 03 ' 27 013a i X X <br /> —Z f S — 7.5`1 PS 03 27 015'v x } X ? <br /> Of -03 -- V 1 a4{ t k <br /> 75 <br /> bg -'03 '27 dSs t X X <br /> S — 4S 09-03 IZ 0 X I <br /> S 6.S or-°3 -27 - 0`' )c t X <br /> _yj PC <br /> 2Z 1 of-03 -�7 42 Y )c x x k <br /> S"8--ZZ 2 0&-01-2 30 Y k` f X X <br /> 31.S V-03-Z? <br /> 45u [ X <br /> 213 -03- 2 �WO ! k k <br /> Z <br /> [coo �` X <br /> 2 I6 0Lu *f <br /> Relinquished by: Date Time R eive "'by: ate Time <br /> Turnaround Time Requested(TAT)(check box) 6 <br /> STD.TAT 1124 hour El 48 hour 31� l 3 - 3 5 <br /> El 5 day El 72 hour El 4 day R linquishe by: Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Recei Date Time <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: tvej� j ❑ate Time <br /> W Surface Water or Groundwater T Triplicate Samplep�, <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other [�'Ij <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) TemperaturelpH Upon Receipt e)6�1 PH Custo Seals I to . Yes #� <br /> i <br /> Lancaster Laboratories,inc.,2425 New Holland Pike,PO Box 12425, Lancaster,PA 17605-2425 (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 />