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LarKwtg L&0rdQCi&SIQ&� Vor La «,ty <br /> +VWXmquakyaasoence ACC.it Sample# Aries <br /> SCR# 3 ] <br /> Analyses Request3ed <br /> FaCBityr# x.5']75 Preservation Codes Preservative Codes <br /> Sloe Address_ nj W��'� KG' '� f�f�y� Lp���C g , Q H=HCI T a Thwsuffate <br /> M=HNO3 B=NaOH <br /> Chevron PM SVI OGIIl`A,-! Lead Consultarrt, S C,R _ S=HZSOa O=Other <br /> Consultant/Office30 k•7 )ql RD S bb R o C 0 ❑ �; ❑a vas reporting needed <br /> Consultant Pq Mgr I3D6 �` <br /> Sb o $ D Must meet lowest detection ImrLs <br /> Consultant Phone p(q,l&) u ya7Fax� �1�� $6�-D43p o Cl � o p Possibler 8260 <br /> forcompounds <br /> Sampler. C`?�!t (�• m g 8021 MTBE Confirmation <br /> p Coadinn highest hit by 8260 <br /> Service order# E]Non SAR 1 ❑Confirm all hits by a2W <br /> FieldRepeat Top Time New m E o X ❑Run_oxy's on highest hit <br /> Point NaMD Wed FigM Pt. 0 V ' 11 Run_oxyrs on all hits <br /> rJV0Ir <br /> Comments f Remarks <br /> r t' 03 /q rayNe ?� <br /> CA?1 $a6 <br /> F a'cks°'l Pte. <br /> o x , <br /> 03 7 11o i5 <br /> Z D <br /> i� <br /> -03 <br /> .00 �cr Wy <br /> Tund Time Requested(TAT)(please arils Rob ulshed by Date Time Received by <br /> D TAT 72 hour 48 hour , 1S Date Time <br /> 24 hour4 daRelinquished try <br /> y 5 day Date Toe Recenred by Date Time <br /> Data Package Options(please drele N required) Relinquished by- Date Time Recenred by Date Time <br /> QC Summary Type I—Full <br /> TYPe VI(Raw Data) D Coelt Deliverable not needed Relinquished by Commercial Carrier R ived by Da Tvne <br /> MP(RWOCS) UPS Disk edFx Other <br /> Tempera#uns Upon Receipt <br /> C. <br /> Custody Sea tact? Yes No <br /> ti 1 <br /> Lancaster l.aboratorles,Inc.,2425 New Holland Price,PO Box 12425,Lancaster,PA 17605-2425 (717)656..2300 3460 Rev 10!04!01 <br /> Copies.White and yellow should accompany samples to Lancaster Laboratories The pink copy should be retained by the client <br />