Laserfiche WebLink
Of Custody <br /> *La <br /> HiStofical Pipeline Po&bfid Analysis 1 •���� 1228 For Lancaster Laboratories use only <br /> tNhele� a5c>inCe Acct.#: 1 Group# Z Z T Sample#: 530 7571 " 55 r <br /> Please print <br /> ,7, Analyses Requested SCR#: 5— <br /> Site/Global JD: N Mo Alh ffa,U De.ye L �t <br /> o� Pav� Sl rC. Preservation Codes <br /> Preservative Codes <br /> Site Address: 1 1CAm ShAl JOAO III AI CO e,4G1 rpg J 1+ H=HCIIF T=Thiosulfate <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIL N= HNO3 i3=NaOH <br /> S=H2SO4 O=Other <br /> Consultant/Office: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 ani <br /> ❑J value reporting needed <br /> 800 Watt Avenue,Suite 210,Sacramento,CA 95821 w EL <br /> — <br /> c� o z PP Risk Assessment Detection <br /> Consultant Prj.Mgr.: JUT W U ❑ ❑ J Lu units <br /> Consultant Phone#: 5j0V66�717� 5 rO ° o o ❑ ❑Chromatograms <br /> Fax#: /Y 7 f ,� 0 <br /> ❑ <br /> Sampler: S4tw Ile �— $ESN £f�Glt y E CD o 0 0 0 Q <br /> 0 Z m OD m u' 'e'� _ <br /> Field 3 Repeal Top Time New o :° w m = _ C. x F <br /> Point Name x Sample Depth Year Month Day Collected Field Pt YIN (7 U H m aLU <br /> r--� O 2..30 Y X x X Comments 1 Remarks <br /> QA T 18 03 �--. <br /> 09 03 17 1 Lt31D I Y � x � Run S;6�el a n <br /> QA—3cAectV A 03 17 15f 7 X<f s a h <br /> 13"2 y✓ p� 03 1 10 yru�n MS51� <br /> "� a3 7 X <br /> o <br /> q — 0 <br /> 03 is 4-5 K -7 3c p)J 4?-x T� g0-11 <br /> 8 0.3 1$ /4t5 4PIpo wti ' S8-21 S8-2 <br /> SB_ Lt W D 68 03 12 1215 <br /> N. <br /> H7 <br /> Turnaround Time Requested(TAT)(check box) Relinquished b2y: Date Time Received by: Date Time <br /> >STD.TAT 1124 hour Eli 48 hour 100 <br /> El5 day El72 hour El4 day Reli Dap Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Receiv Date Time <br /> S Soil D Duplicate sample <br /> W Surface Water or Groundwater T Triplicate Sample Relinquished b erdal Carrier: Rec ved by: <br /> T TriBlank-QA Sample N to Time <br /> Trip P Pre-Purge Sample UPS ed Other <br /> R Rinsate Blank-QA Sample P Past-Purge Sample G r Ill <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt t' — C. H <br /> P ustody Seals Intact? a No <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 />