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Histoncal Pipeline Porfiblid AnalysisRequestlChain 1 Custody <br /> *bmaster��l l�J jL 3 g l 4 (� { 2 For Lancaster <br /> (Laboratories use only 1 <br /> vwvregAAYisasckerx-e. Acct.M i f i 1 3 Group# I C}g T 0! 7 Sample#: 53 j S,52 f <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: Preservation Codes Preservative Codes <br /> H=HCI T=Thiosulfate <br /> Site Address: IrOL tjA <br /> N=HNO3 B=NaOH <br /> to <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant. AlC S=H2SO4 O=Other <br /> U <br /> Consultant/Office: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 N ❑J value reporting needed <br /> &800 Watt Avenue,Suite 210,Sacramento,CA 95821 c ❑ z HPP Risk Assessment Detection <br /> O Limits <br /> Consultant Prj.Mgr.: ❑ ❑ El Lou <br /> J_ . R o 0 0 © of o <br /> _ ❑Chromatograms <br /> Consultant Phone#: Fax#:�h1 G —6/f�� I9 m co CO <br /> .0 ❑ ❑ r" o 0 0 <br /> Sampler: 1/ co Z � 00 N <br /> OL co C.Field Repeat Top Time Newo w Co co co <br /> Lu <br /> Point Name Matrix Sample Depth Year Month Day Collected Field PtYIN C7 U m a <br /> 63 3 Comments!Remarks <br /> Turnaround Time Requested(TAT)(check box) Relinquished by: DOW Time Received by: Date Time <br /> TD.TAT El hour El hour <br /> 631.5 day El 72 hour El day R quished by: to <br /> Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time ceived Date Time <br /> S Soil D Duplicate sample Relin al Carrier: Receive by Date Time <br /> W Surface Water or Groundwater T Triplicate Sample f ' ii 0 <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx ther <br /> R Rlnsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt C° pH Cu4y Seals Intact? 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 />