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Histolical RiPefine Portfolio AnalysisRequestlChain1 1 • <br /> Lancaster LabOrdtOriW 1228 For Lancaster Laboratories use only <br /> Wherequality,sasc ce y 3 <br /> Acct.#: Group# [0gZZLO Sample#: �30�S�1 - <br /> Please print � <br /> j ,� Analyses Requested SCR#: S[� I rte� <br /> Site/Global ID:mo(� TAih tf 6(is e, Deye�pf me -r s111E 7#76 Preservation Codes Preservative Codes <br /> Site Address: 1 1 7. MAI JOAO UfAII co 12At,I r—C4.6j 11+ H =HCI T=Thiosulfate <br /> N= HNO3 B= NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC ro S=H2SO4 O=Other <br /> Consultant/Office: 13401 Alberto Way,Suite B,Los Gatos,CA 95032 <br /> ❑J value reporting needed <br /> X800 Watt Avenue,Suite 210,Sacramento,CA 95821 <br /> n TT- WHIT?- <br /> + o to z PP Risk Assessment Detection <br /> Consultant Prj.Mgr.: Jc. WH U © ❑ J � o � imits <br /> Fax#: y�rp ! 1 o o M U ❑Chromatograms <br /> Consultant Phone M (C51D� o�717� 5�O N N <br /> c� c e 0 m m L5 0 0 U <br /> Sampler: _411 J�I x f 55,414 �i�L r LC E K. 0 0 0 0 M <br /> f aZ � o � � U) <br /> Field Repeat Top Time - Now � E -2 x w ° Zo CO Q <br /> Point Namex Sample Depth Year Month Day Collected Field Pt YIN � U ~°- @ � < � F- <br /> 10--v 10-' 2-30 Y X7 x X Comments f Remarks <br /> QA T —' 6$ 03 �---,- � '�1 a � <br /> SB°- '�I/ OF n3 f 7 fl Y Z un S_� <br /> 17 �51t <br /> 6�-2 �-- — D$ 03 r i� 2t <br /> 3 r ? o ? x2u� <br /> q - o -" os O 3 S ' 4 5 7 x 0 � _,� c <br /> 8 0 � 18 1Lt5 row ' S —Z <br /> 58— w D — 03 r2 tz15 <br /> Turnaround Time Requested (TAT)(check box) Relinquished by: Date Time Received by: Date Ti P <br /> XSTD.TAT El 24 hour ❑48 hour <br /> ❑ 5 day ❑ 72 hour ❑4 day Relin e ( t Time Received b <br /> Y Date Tim-- <br /> Matrix <br /> imeMatrix Values Repeat Values Relinquished by: Date Time Rece <br /> Y Date I T mA <br /> 5 Soil D Duplicate sample <br /> I <br /> W Surface Water or Groundwater T Triplicate Sample Relinquishedmmercial Carrier: Re ived by: Date i Ti n< <br /> T Trip Blank-CA Sample N Pre-Purge Sample UPS ed E Other <br /> R Rinsate Blank-CA Sample P Post-Purge Sample � �9 !Q1 if-a447 Miscellaneous(e.g.,product sample) <br /> Temperature/pH Upon Receipt . Co <br /> PH Custody Seals intact? No <br /> Lancaster Laboratories,Inc.,2425 Neuf Hollar"Pike,PO Box 12425,Lancaster.PA 17605-2425 (,'717)656-2300 4324 01 Rev- 1.114:05 <br /> Copies:White and vellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />