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MEMO=, <br /> &- =, <br /> a <br /> I � <br /> V <br /> 1 <br /> 0 <br /> .,,.} � .,{� } For Lancaster Latroratories use only <br /> Lancaster[2boratorles Accl 11- Sample 0 SCRI! <br />� tMx�equa6tyrsascl�nc� <br /> Analyses Requested <br /> K!a '� . Mafr(x Preservation Codes Preservative Costes M <br /> Facility# "1 � '� _ H=Hct i=Thiesulfate <br /> Site Address �� Q �Cs C N=HNO, B=NaOH <br /> S =H2SO4 O Other <br /> fsa <br /> — <br /> -Chevronp---- adiConsultant z <br /> a N IN <br /> C1 value reporting needed e <br /> Gansu[lanl101fice Ck F l A o 9 5 Q C3 Must meel lowest detedwo fimlt• <br /> possible far 8260 wmpounds e <br /> Consultant Prl Mgr r i� (� © 1 Q `° � <br /> 8021 MTSE Confmnabon <br /> Consultant Phone# Fax#_ w [04 <br /> 0 []Confifm MTBE+Naphthalene <br /> Sam ler E m a 0 1 C]Contimn highest hit by 8260 <br /> PW z Z z = 3 s ❑Confirm all has by 8260 <br /> Service Order# ❑Non SAR r _ <br /> JE Y w a ❑Run_oxys on hrghesk hit <br /> Data T1me �l 7 ❑Run orcys on all lids <br /> Sara le Identification Collected Collected N D m <br /> 3 y U �- �(' Y Comments!Remarks <br /> r <br /> 7 a <br /> T <br /> A <br /> 1 <br /> I <br /> Relinquished by D le r�� Received by to Time <br /> Turnaround Time Requested(TAT)(please circle) <br /> STO TAT 72 hour 48 hour Relinquished by le Time cc ed Date Time <br /> 24 hour 4 day 5 day <br /> flats Package Options(pleats coda If required) Relinquished by Dale Time Received by- <br /> Data <br /> y Date Time <br /> QC Sarimary Type I-Full Relinquished bVCOMMIClal Carrier Recetyed by Dale Time <br /> Type V!(Raw Data) Disk l EDD UPS FedEx Other <br /> � tAf1P(RWQC9) <br /> Standard Format <br /> Disk other Temperature Upon►Receipt C° Gualody Seals Intact° Yes No <br /> Lancaster Laboratories,Ina 2425 New Notlaed Pikt^PO Box 12425,Lancaster,PA 17605.2426 (717)656-2340 3566 Rev 1131A <br /> Coples White and yellow should accompany samples to Lancaster Labaratudes The pink copy should be telamed by The client <br /> A <br />