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ir <br /> Chevron California f�,=g'ion Analysis RequestlChain of Cus"i'idy <br /> LW.d�P.1'LabO�► flex <br /> For sb <br /> Asci t�� Sampb t scR#- <br /> Wheregcealrtysasaen[� , <br /> Analyses Requested <br /> Facility# _ �� 577.E �� I Preserva4ion Codes Preservative Godes <br /> ,/ H=HCI T=Thcosuttate <br /> Site Address 30J G✓' �SGy �„or. 10. �0e H=HNO3 B=NaOH <br /> Chevron PM Lead IlO)nsuftanl SE 60/-, S=Hz50a O=Other <br /> ConsultantlOffee -3ol7 K�c� R597140 kc� � D S D J value reporting needed <br /> O Must meet lowest detection lands <br /> Consultant Pq Mgr •aa J'1a1— 1 a Possible for 8260 compounds <br /> I! R El <br /> Consultant Phone t 9.�—�d/-a�� "Fax it y�6^�$'6l--QI `f.�o & N 8021 MTBE Confirmation <br /> Sampler s�r�_t �0 ! p Confirm highest hit by also <br /> Servrce Order# ❑No I SAR I Z <br /> w �El I]Confirm all hes by 626o <br /> Field Repeat Top E Tune New v $g ❑Run oxy s on highest hit <br /> Point Narne mpler Mo c� h $a O Run_oxy's on aU hits <br /> ii $ Comments 1 Remarks <br />� E <br /> I � <br /> Relc Qats Time Received by- Date Time <br /> Turnaround Time Requested(TAT)(please arae) 6` <br /> STD TAT 72 hour 48 hour Relinqu led by- Time Rsoapmd by Date Time <br /> 24 hour 4 day <br /> Reim heli toy Date Time raved by Date rime <br /> Data Package Options(please c+rde if required) <br /> QC Summary Type I-Fall III <br /> Type\11(Raw Data) ❑Coelt Deliverable not needed ReAnqurahetl Carrier rued try Date Time <br /> WIP(RWQCB) I UPS ?edETx Other 3to <br /> Disk Temperature, C. Custody Seals Intact? es No <br /> II <br /> Inc,2425 Nowu a Valid Pike,PO Bac TiAQW14US (YW656-2300 3460 Rev 10/04/01 <br /> Copies white anil yellow should accompany samples to Lancaster Laborifties. The pink copy should to raWried by the d*nt <br />