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Chevron CalifomiaR. Analysis <br /> For Lancaster Laboratories use only <br /> Laboratories Acct.#: C , � Sample#: 0 16+Lancager <br /> SCR#: <br /> Where civalrty u a science. <br /> Analyses Requested <br /> Preservation Codes Preservative Codes <br /> Facility#: a1 11H =HCI T=Thiosulfate <br /> Site Address: A, g N= HNO3 B=NaOH <br /> S= H2SO4 0=Other <br /> Chevron PM: Lead Consultant: ;n 0 <br /> C3z C1J value reporting needed <br /> Consultant/Office: m N B D Must meet lowest detection limits <br /> c possible for 8260 compounds <br /> Consultant Prj. Mgr.: ° <br /> o � O 8021 MTBE Confirmation <br /> Consultant Phone* g!G '�i!ol Yo CD Fax M � " c� o � A <br /> ❑Confirm highest hit by 8260 <br /> Sampler: °= E m ua _ _ El Confirm all hits by 8260 <br /> 2 IR <br /> Q <br /> Service Order#: ❑Non SAR: ¢ Z + 4 0 o ❑Run^oxy's on highest hit <br /> Field Repeat Top Time New o o r i ❑Run^oxy's on all hits <br /> Point Name Matrix Sam le Denth Year Month Da Collected Field Pt. C7 U m J <br /> -Zt�• d lZ3D � Comments 1 Remarks <br /> 100 <br /> r� lZ3S 1 <br /> i <br /> L--Z- <br /> - <br /> 11ST2 -Z <br /> _Z 13co l <br /> �-Z <br /> dao <br /> -2 L ,!ytafl <br /> -JA FVPVL 1 1 1 / 1 1 <br /> Reli ' e Date Time Received by: Date Time <br /> T nd Time Requested(TAT)(please circle) d63 !¢tip <br /> S T 72 hour 48 hour Relr ed by: Date Time b : Date Time <br /> 24 hour 4 day 5 day <br /> Relinquished by: Date Time Received by: Da e e <br /> Data Package Options(please circle if required) <br /> QC Summary Type I—Full Relinquished o menial Carrier: R ived by: a Time <br /> Type VI(Raw Data) ❑Coeit Deliverable not needed UPS q FedEx Other " 1 r ' a � <br /> WIP(RWQCB) c o Custod Seal n Ct? es o <br /> Disk Temperature Upon Receipt C y <br /> i <br /> 3460 Rev. 10/04101 <br /> Lancaster Laboratories, Inc.,2425 New Holland Pike,PO Box 12425, Lancaster,PA 17605-2425 (717)656-2300 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />