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�.aliforniax-,,.gions - <br /> Lancaster laboratories For Ls star Laborabta 6 <br /> s use only `// <br /> Acct.M 1 C c1Q Sample#:yJ C11 4t SCR#: / V <br /> Meegtralitytsasaer►ce. Analyses Requested <br /> Facility M q-os57 Matrix Preservation Codes Preservative Codes <br /> H =HCI T=Thiosutfete <br /> Site Address: X19 S ecy,L 5e- __ 6�- 4 C N= HNO3 B=NaOH <br /> S=H2SO4 O=Other <br /> Chevron PMY_Z/-i�f c Li rekrt __Lead Consultant: /L <br /> 200) C ❑J value reporting needed <br /> Consultant/Office: Lou ❑ 8 <br /> a D- q N 8 ❑Must meet lowest detection limits <br /> a z q m possible for 8260 compounds <br /> Consultant Pd.Mgr.:��,.�,�/ /�.. .-� _ ❑❑ tiEL ❑ <br /> Consultant Phone#: 4ir.-moi�s _ Fax#: a o 6021 MTBE Confirmation <br /> arcoQ w A ❑Confirm highest hit by 8260 <br /> SamplerHG//CLQ E m ❑ `f p Confirm all hits by 8260 <br /> Service Order#: ❑Non SAR: o Q z 5 �2 R � <br /> E + $ $ ❑Run oxy s on highest hit <br /> Date Time o 'o © o _ �- Run <br /> ___ oxy s on all hits <br /> Sample Identification Collected Collected 0 v rn 3: O � m � � � o <br /> Comments!Remarks <br /> I' <br /> s;S <br /> Relinquished by: Date Time R ed by: Date Time <br /> Turnaround Time Requested(TAT)(please circle) <br /> STD.T 72 hour 48 hour Relinquished by: Date Time Received by: Date Time <br /> 24 hour 4 day 5 day - <br /> -Y5.0 <br /> Data Package Options(please circle K required) Relinquished by: Date Time Received by: Date <br /> QC Summary Type I—Fall <br /> Type VI(Raw Data) [ICoelt Deliverable not needed Relinquished raai Carrier: 7ed by: bate Time <br /> WIP(RWQCB) UPS FedEx Other <br /> Disk Temperature Upon Receipt o Custody Seals Yes No ' <br /> Lancaster Laboratories,inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 3460 Rev.7130101 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br /> I <br />