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i <br /> Histofical Pipeline Ponl6fid Analysis RequestlChain of Custody <br /> *Laffaster Lkm&rRs 0961 l For Lancaster Lab�oiratories use only <br /> L <br /> Mee . Acct.#: 1 Group#/1-1 i0q ! Sample#: .!5 53-7) ;P <br /> Please print Analyses Requested SCR#: <br /> SitelGlobal ID: Preservation Codes Preservative Codes <br /> A H=HCI T=Thiosulfate <br /> Site Address: i G (.0et>k rcn9A., C N =HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mans olt Lead Con Ita t:SAIC d S=H2SO4 O=Other <br /> Woose��s "CA gqcge 7 In <br /> Consultant/Office: 40" ° "r *��.,��n n N N <br /> "' c ❑J value reporting needed <br /> .M � a <br /> ❑ <br /> 3800 Watt Avenue,Suite 210,Sacramento,CA 95821 0 �, z KHPP Risk Assessment Detection <br /> Consultant Pd.Mgr.: 3}V5ri"-, j�" U ❑ Cl 0 Limits <br /> LU <br /> U <br /> _ ,I q o � N ❑ 0 0 U ❑Chromatograms <br /> Consultant Phone#: 1 Fax#: �0 WAO 1119 Q o 0E] co 0 a0 .0 <br /> Sampler: !'1 a►� .eZ ` Ir rl n� y N " r ,t, U <br /> co co N <br /> Q- cc O O J <br /> Field Repeat Top Time Now Z o o w m = _ = a w <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN 01 U H m a <br /> Comments!Remarks <br /> UP <br /> - — -- vq i <br /> CM <br /> un <br /> ih5�`t1° rr3t� <br /> Turnaround Time Requested(TAT)(check box) Relinquishe _ e Time ceived by: Date Time <br /> ISTD.TAT ❑ 24 hour ❑48 hour 3m <br /> El day El 72 hour ❑4 day is a ate Time Received by: Date Time. <br /> Matrix Values Repeat Values Relinquished by: Date Time Received by: Time <br /> S Soil D Duplicate sample Relinquished by Commercial Carrier: ived by: aa Time <br /> W Surface Water or Groundwater T Triplicate Sample � <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS r Other <br /> I R Rn sate Blank-QA Sample P Post-Purge Sample r <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt ,S¢a Co pH Custo S Is Intact? Yes No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (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 />`\ <br />