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Historical e • + • • 1AnalysisRequestlChainofCustody <br /> 093 .5 �, i For Lancaster Laboratories use only <br /> Meequdl iSaS&MM- Acct.#: l•� Group#I 7rOL4(c Sample#: <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: Preservation Codes Preservative Codes <br /> H= HCI T=Thiasulfate <br /> Site Address: {71 N= HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott ManshoV Lead Consults t:SAIC L S= H2SO4 O=Other <br /> .� ° att &� 7 5 -1�e�0 to <br /> Consultant/0-fice: <br /> V----+r"einerr,04Z} ' } �s c� ❑J value reporting needed <br /> co <br /> El3800 Watt Avenue,Suite 210,Sacramento,CA 95821 0 ❑ u, - H P P Risk Assessment Detection <br /> Consultant Prj.Mgr.: ,, V7Z]4� yi�Q t — ❑ Limits <br /> U ❑ a <br /> � <br /> 1 -7919 <br /> Q 0 0 o� ❑Chromatograms <br /> Consultant Phone#: 5_1C Fax#: 4—t Io `7 q 0 79 1 -f a) CO) <br /> m -0 U' o <br /> Sampler: ' `tGr' ` F Y-r" <br /> Z co o <br /> co co <br /> Field Repeat Top Time New o o Lu z a <br /> oin#Name Matrix Sample Depth Year Month Day Collected Field Pt YIN 0 l'— m a <br /> j — .2- I5 Comments 1 Remarks <br /> S - © 3 Y n^ <br /> 6q <br /> 1� P <br /> UrTurnaround Time Requested(TAT)(check box) Relinqui y: Time Re by: Date Time <br /> , STD.TAT ❑ 24 hour ❑ 48 hourdv <br /> El5 day El72 hour 1:14 day a I Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: ate Time Received by: Date e <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: Re by: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample _ <br /> T Trip Blank-QA Sample N Pre-Purge Sample UP Otheril j r <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt L Co pH Custody S Intact? Me <br /> No <br /> Lancaster Laboratories,Inc.,2425 New Holtand Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 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 />