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+LarxasternQs � (�a For Lancast r Lab o to only <br /> VVIwe t,&tytsasaence- Acct # Sample# 3 -es s� _ SCR# !f// <br /> Analyses Requested <br /> Facilq# 7 Matrix Preservation Codes Preservative Codes <br /> Site Address tn} H=HCi T=Throsuifate <br /> i CL N=HNO3 B=NaOH <br /> Chevron PML-V Consultant S Q(:�'l, U S=H2SO4 0=Other <br /> Consultant/Office —SQ( fr7�may,OM }. p 0 ❑ y�j ❑J value reporting needed <br /> Consultant Pr) Mgr 1/ a° z o ❑Must meet lowest detection limits <br /> _ 110 U ❑ possible for 8260 compounds <br /> Consultant Phone# — 9 — Fax# i . — o & ❑ <br /> L� CM o(D I= N 8021 MTBE Confirmation <br /> Sampler <br /> ❑ Cc o <br /> CD ^ ❑Confirm highest hit by 8260 <br /> ES R I <br /> Service lce Order# ❑Non SAR I z � t D Conium ail hits by 8260 <br /> Date TlmeoE — � © � + � ❑Run_oxy s on highest hit <br /> Sam fe Identification Collected Collected C7 C) 3 if I ❑Run'oxy s on all hits <br /> 02213' X X x x Comments 1 Remarks <br /> �d- 0?2 '3 � x x <br /> gid- 1 .S/ k X k <br /> Z' :o x X x <br /> ' 5 <br /> I <br /> I <br /> Turnaround Time Requested(TAT)(please cirde) Relinquished by Date Time Received by Date Time <br /> STD 75-63 40 F 3 TAT 72 hour 48 hour Reli ui ed b <br /> 24 hour 4 day 5 day Y Date Ti nr <br /> ry j� <br /> Data Package Options(please circle If required) elinqulshed by_ Date Time Received by Date Time <br /> QC Summary Type I--Full <br /> Type VI(Raw Data) ❑Coeft Deliverable not needed Relinquished rcial Camer Re iv by Date Time <br /> WIP(RWQCB) UPS edEx Other boA ;q �, io_ _& OqI <br /> Disk Temperature Upon Receipt--CqAIL Co Custody Seals 7 Yes <br /> Lancaster Laboratories,inc,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 3460 Rev 7130!01 <br /> Copies Waite and yellow should aocornpafly 38Mples to Lancaster Laboratories The pink copy should be retained by the client <br />