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Historical Pipeline PonYofio Anolysts RequestlChoin of Custody <br /> Lai I L& WeS 1230 For Lancaster Laboratories use only <br /> Vlyequa4isascOrve. r — <br /> Acct.#: Group#1 a{1�r Sample#: S I <br /> Please print �rAnalyses Requested SCR#: <br /> �1 <br /> Site/Global ID: Aiou r AIN 140USrCO Preservation Codes Preservative Codes <br /> FR4CY, H=HCI T=Thiosulfate <br /> Site Address: N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC a S= H2SO4 O=Other <br /> L U <br /> Consultant/Office: ❑401 Alba a Wa ,Suit B,Los Gatos CA 9503 a ❑J value reporting needed <br /> t000 R�Y►�WAT.Svtxfpl flk►cL4j%Q cA 14&o7 <br /> 3800 Watt Avenue,StJ�te 210,Sacramento,CA 9521 115 = z PP Risk Assessment Detection <br /> f E El El Consultant Pd.Mgr.: F F WN!M U o <br /> �.1 <br /> o �, ❑ 0 = ❑Chromatograms <br /> Consultant Phone#: %710 -7 17 5 Fax#: S/0•V 61P-7 1/1 a o o <br /> m m co <br /> Sampler: L. SlLVA S. 4C=141-lice n E � o 0 0 0 <br /> Z co co N V �2 V <br /> o <br /> Field Repeat Top Time New m 0 0 w m = _ = x <br /> Point Name Matrix Sample Depth Year on Day Collected FleM Pt YIN 0.1 U m M a � � M <br /> _58-15, -315 d 1 1¢10 7- )( X X Comments 1 Remarks <br /> tRIFAAtiK w w 24 0500 o x 2 X X IFTPyD,pbmcmvl <br /> PWTV61067. W N — ?400 3124 +7&0 N X X X AL$0 .4N44,Y1-,F,-- <br /> N a–[s ins is 0g60 Y :;L X -A 51i m <br /> 04– / hI — 3 09,10 Uft,C-LEA4N UP, <br /> Turnaround Time Requested(TAT)(check box) Rel' q hed by: Dat# Time Received by: Date Time <br /> STD.TAT ❑24 hour ❑48 hour <br /> ❑ 5 day ❑72 hour ❑ 4 day Relingw y: Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Recei y: Date Time <br /> S Soil D Duplicate sample Relinquished mercia!Carrier: Re �ved by: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS Fec! Other <br /> R Rinsate Blank-QA Sam pie P Post-Purge Sample ovO <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt C° pH Custody Seals Intact? �9//, o <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-24 [717]656-2300 4324.01 Rev. 1114/05 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />