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1 9 <br /> Lamaster Laboratodes i,� For Lancaster Laboratories use only <br /> iMjerequa6tyaasoence <br /> Acct.a "�"r L Sample#� SCRM- <br /> Analyses Requested <br /> Faa '?--577715' Pmer+ratlon Codes Preservative Codes <br /> H=HCI T=Throsulfate <br /> Site Address - 'f ti/ N=HNO3 B=NaOH <br /> Chalon PM.-0.0L <MMC7AA*.% Lead Consuttanb In � S=H2SO4 O=Other <br /> Consultant0fte AW-7 mm_ ❑ c ❑J value reporting needed <br /> � N <br /> ❑Must� g60 dehKim sm� <br /> Consuliant Pq Mgr ssbfor <br /> Consultant Phone t F <br /> 8021 MME Confirmation <br /> J cs d a <br /> Sampier' �T—, d E 9 ^ ❑Confirm highest hit 6y 8260 <br /> Service Order# <br /> Non SAR ° Z �, m R ❑Confirm all hits 8260 <br /> PField c Repeat Top Time New � E � ❑Run_m ys on highest bit <br /> fid F- m ©Run_oxys on eN his <br /> $ Commerft 1 Remarks <br /> io,aocMc <br /> a- <br /> t <br /> Reiinq fished by #Da% rune nfed by- Date <br /> nd Time Riquested(TATT(pleasedrcle) <br /> k24 <br /> TRT 72 hoar 48 hour liDate Time Received Date Time r 4 day 5 day <br /> Data okage Options(please crrde if required) RebnquEarred by Data Tune Received by Date Time <br /> QC SurhmarA Type I-Full <br /> Relinquished b roar rner <br /> Type Vi(Raw Data) Q Cdelt Deliverable not needed Date jrMe, <br /> IMP(RWQCB) UPS FedEx x cher <br /> Disk _ Temperature Upon Receipt E° ustodylntach Les0 <br /> Lancaster LaboratorWi,Inc.,2424 New Holland Pyre,PO'Box 12425,Larzaster,PA 17605-2425 (7M65e-23o0 3460 Rev 10AM1 <br /> Copds.White and yellow should accompany samples to Lancaster Laboratories The pink copy should be retained by the client <br />