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Histofical Pipeline ' • • • AnalysisRequestlChainofCustody <br /> +Lwcaster 123V For Lancaster Laboratories use only <br /> UVharequrdfity¢asrietxe � RC1!'3 Acct.#: Group# �o {(�q� Sample#: <br /> �3fB,6-95--(POO <br /> Please print nt ✓ SCR# <br /> ,033 � AnalYses Reqnested <br /> Site/Global ID: ; ( Preservation Codes Preservative Codes <br /> Site Address: N=HNO3 g=Na°O� .{Ifate <br /> ChevronTexaco Phil:M.Cott Mansholt Lead Consult t:SAIC S= H2SO4 O=Other <br /> i U <br /> Con sulta nt/Offioe: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032C 0 ❑J value reporting needed <br /> EL <br /> PP Risk Assessment Detection <br /> 3800 Watt Avenue,Suite 210,Sacramento,CA 95821 � � co2 Limits <br /> Consultant Prj.Mgr.: �+' ��Li �"L iJ b0 © © 0 = U ❑Chromatograms <br /> i o c, U <br /> Consultant Phone#: Fax#: � t;1� � � .0 �c ❑ � o o <br /> Sampler: r ' PLsg I Le = N N C) z 2 � <br /> Q Z co 0o c4 `� "' U <br /> O O co J <br /> Field Repeat Top Time New o - w m z = = _ <br /> Lu <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN C7 L) m a <br /> �lZ Comments/!Remarks <br /> CRk <br /> �" 0 0 Com, X rj 'St Il'c f <br /> z I -L9 Ll y X <br /> 6903 7- CQ <br /> D <br /> 03 3f <br /> p X `] <br /> 7T <br /> ;�ZDr. <br /> ound Time Requested(TAT)(check box) Relinquished by: r' ate Time Receved by: Date Time <br /> 08 200 } 3t 12(:� <br /> TAT El 24 hour El 48 hour <br /> El 5 day El 72 hour ❑ 4 day Relinqu' ed by: 66 Time a ive y: to Time <br /> 3/3rd f is 8 ZA <br /> Matrix Values Repeat Values R inquishe i Date Time Rec Date Time <br /> r <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: (!.&ved Date Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-GA Sample N Pre-Purge Sample UPS x Other i <br /> R Rinsate Blank-GA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Femperature/pM- pot <br /> n Receipt pH Cu dy Seals Int c Yes <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 />