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Chevron • Region • <br /> 1Cus <br /> : • • <br /> For L�ca,e� tores _e only Laboratories Acct 0. Sample# �77L5yVVeregw6tyi5asoence. _e5o <br /> 1211sAnalyses Requested <br /> Facility#: CPL- Tfa" II'd-M 15 t. s Preservation Codes Preservative Codes <br /> Site Address: 't'facy V,L rA 1 S1. 57 H = HCI T= Thiosulfate <br /> N = HNO3 B = NaOH <br /> Chevron PM: Lead Consultant: H 1 N S = H2SO4 O= Other <br /> Consultant/Office: — c to i ° O J value reporting needed <br /> V / O Must meet lowest detection limits <br /> Consultant P6. Mgr.: /'/'1 `/ c lr,'hn,w��� U O V O (C�, possible for 8260 compounds <br /> Consultant Phone#:1/� D /�l?d� -};S 3 Fax#: �0 11[D -q/�O `o g El <br /> o� v 8021 MTBE Confirmation <br /> Sampler: �t[ff+� ,>t bvtlk....�r y E m o o ;, O Confirm highest hit by 8260 1 <br /> 0 L 0 Confirm all hits b 8260 <br /> Service Order#: O Non SAR: o Z r N 0 y <br /> a a -X G Run_oxy's on highest hit <br /> Field Repeal Top Time New m o n.. <br /> Point Nam Matrix am le Denth Year Month Da Collected Field C7 U � m a a � I � f" ❑Run_oxy's on all hits <br /> Comments/Remarks <br /> Past a�• t T'Nc.r = Gr�1e o�\ <br /> Swa-3 ` a 2- <br /> Ti <br /> D to <br /> Turnaround me Relinquished Time Receiv Date Time Requested (TAT)(please circle) O <br /> 72 hour 48 hour RZu d Date Time Received by. ate Time <br /> 4 day 5 day 0j <br /> Data Package Options (please circle if required) Relinquished by: D to Time /Reef, ived by: D e Time <br /> QC Summary Type I–Full <br /> Relinquished by Commercial C rier: Recei <br /> Type VI(Raw Data) QCoelt Deliverable not needed � Date Ti e <br /> WIP(RWQCB) <br /> UPS FedEx Other ��f1 <br /> Disk Temperature Upon Receipt /A C. Custody Se Intact? es No <br /> Lancaster Laboratories, Inc.,2425 New Holland Pike, 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 />