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1 • • • Region • `e• - 1 ofCustody <br /> IFor Lancaster L�abooratories 6 only f <br /> *Lancwtff Labs Ci or� Acct.#E: Sample#:. 900( "l SCR#:41��rp is a saeroce. <br /> Analyses Requested (20-9 ti-ga3i 3� <br /> Facility#: Matrix Preservation Codes Preservative Codes <br /> H=HCi T=Thiosulfate <br /> Site Address: 1,2364"56 S&X�t3t�1 C 4CL N=HNOs 8=NaOH <br /> S=H2SO4 0=Other <br /> Chevron P 1- Lead Consultant:_Sn-n <br /> _ � � � El [IJ value reporting needed <br /> Consultant/Office: '� a 0- _ $ ❑Must meet lowest detection limits <br /> Consultant Prj. Mg a in possible for 8260 compounds <br /> Consultant Phone#: a- aCo� <br /> -0���s _ Fax#: - �' ❑❑ o g 8021 MTBE Confirmation <br /> 0 co ❑Confirm highest hit by 8260 <br /> Sampler: _� �,._i�� h- -- ❑ E S C © ❑Confirm all hits by 82260 <br /> Service Order#: [:]Non SAR: o Q z Ln <br /> CL + $ o ❑Run_oxy s on highest hit <br /> Date Time M o •o m o ' a ❑Run_oxy s on all hits <br /> Sample Identification Collected Collected 0 U rn O m <br /> Comments 1 Remarks <br /> j <br /> 6 <br /> X—ju <br /> >! <br /> Q --- I IX a <br /> Relinquished b Pate Ti Received by: Date Time <br /> Turnaround Time Requested (TAT)(please circle) O /M�3 1 <br /> D.TAT 72 hour 48 hour Relinquished by: t Date Time Received by: Date Time <br /> 24 hour 4 day 5 day <br /> Data Package Options(please circle if required) Relinquished by: J r _ -D913-- Time Received by: Date \ <br /> QC Summary Type I-Full Relinquished by Commercial Carrier: Received by: I Date Time <br /> Type VI(Raw Data) ©Coeit Deliverable not needed r� <br /> WIP(RWQCB) UPS Fac Other <br /> Disk Temperature Receipt '^ C. Custody Seals Intact? es No <br /> Lancaster laboratories,Inc.,2425 New Holland Pik -x12425,Lancaster,PA 17605.2425 (717)656-2300 or <br /> 0 Rev.7130101 <br /> Copies:White and yellow should accompany samples to La aboratories. The pink copy should be retained by the client. <br />