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PipelineHistorical Port.,lofid Analysis RequestlChain <br /> Lam ter Uodtories 1033 For Lancaster Laboratories use only '7 /,, <br /> t Tegja 'isdSC CE. Acct.#: 13 Group# I QB?,V SS S <br /> Sample#: 3 1 <br /> ) q 3 73W <br /> Please print Analyses Requested SCR#: <br /> Site/Global€D: Mt1wmtj 44Qu-a to Preservation Codes Preservative Codes <br /> Site Address: i Kf�G� rd a #i =HCI T=Thiosulfate <br /> r�. = N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC (D S=H2SO4 O=Other <br /> to U -21 <br /> Cons uitant/Office: ❑4 1 Ale a S e Los Gat s C 95032 t� <br /> 3Q x,00 w, wilco 9 i j 6� � 0��,Q — ❑J value reporting needed <br /> W �'U !0"]5 7J �a V � <br /> z P Risk Assessment Detection <br /> Limits <br /> Consultant Pd.Mgr.: �aFF LU <br /> W Fi trr U El ElJ <br /> oN N ❑ b El C h romatog ra ms <br /> Consultant Phone#: 610-409-7Q6 Fax#: bto — i1`1co <br /> m El C, <br /> o 2o < <br /> Sampler: .•S1 LJA L 66L y o M MQ <br /> O ZC14 Um <br /> 00 N i2 <br /> Field Repeat Top Time New m E m w m = __ �= a <br /> CL U-1 <br /> Point Name Matrix Sample Depth Year Mo th ay Collected Field R YM C7 0 H m 0- a a <br /> TLAhl W N Z.OD S 0 Comments I Remarks <br /> sB- a vv N 00 b 3 ZS IF- TPQ D llgawv) <br /> -� s5twcA <br /> C-,�I✓ Ct,�nlu� <br /> Turnaround Time Requested(TAT)(check box) R 'shed by: Itatel Time Received by: Date Time <br /> TD.TAT El 24 hour El 48 hour `3 <br /> 5 day El 72 hour El day R ui d by: Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time Received by.// <br /> y. Date Time <br /> S Soil D Duplicate sample Relinquished by mmercial Carrier: Rece' d y: Date Time <br /> Surface Water or Groundwater <br /> W SurT Triplicate Sample 27 <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedE Other <br /> R Rinsate Blank-QA Sample P Post-Purge Sample b6Vx4,&, � <br /> 16900 <br /> M Miscellaneous(e.g.,product sample) TemperaturelpH Upon Receipt 3. C° pH Cus ody Seals Intact? a No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 {717}856-2300 4324.01 Rev.1/14105 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />