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Historical PipelinePorldifid AnalysisRequestlChain of Custody <br /> 1p11 For Lancaster Laboratories use only+Lw_wWL&mb* <br /> VVherec iityaasu+ence Acct.M Grou # Sample#: 1 <br /> Group 1-1)R* p o y ink <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: 5ffEPreservation Codes Preservative Codes <br /> Site Address: d 0 IJ H=HCI T=Thiosulfate <br /> N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead ul nt:SAI S=H2SO4 O=Other <br /> w ,- ko%r�, N"ZA 9 &0 7 � <br /> Consultant/Office: _"'.2x r °} Z N <br /> wS a ❑J value reporting needed <br /> El 3800 Watt Avenue,Suite 210,Sacramento,CA 95821 a N Z KPP Risk Assessment Detection <br /> Consultant Prj.Mgr.:�1�,xT lV ^7:66a!, U ❑ © J A 0 0 Limits <br /> . <br /> © iC. <br /> ❑ 0 W W []Chromatograms <br /> Consultant Phone#: J 6 %a(V (-{ Fax#:ego qq(I Y� <br /> ® ❑ u' O O O <br /> Sampler: n ��j c0 0 0 M M M a <br /> L pip W N In V <br /> 0 O O " J <br /> Field Repeat Top Time ° o o Lu CO <br /> Ld co <br /> co a = ~ <br /> Point Name Matrix Sample Depth Year Month Day Collected Feld Pt YIN v 1- LU <br /> m t- <br /> 0 Comments!Remarks <br /> — i <br /> L <br /> cod 2 r <br /> Turnaround Time Requested(TAT)(check box) Relinquished by: Date Time Re by: Date Time <br /> 19�STD.TAT El 24 hour El 48 hour <br /> El 5 day El 72 hour 114 day Rel inq by: Date Time Received by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Hate Time Received by: ate Time <br /> S Soil D Duplicate sample Relinquish mmercial Carrier. Received by: Date Tlme <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T TripBlank-OASample N Pre-Purge Sample UPS FedEx Other L_—, i U <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt pH Custody lals Intact? Ye No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17805-2425 (717)656-2300 4324.01 Rev. 1/14/05 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />