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' � <br /> ;;;44L) 680 Chesapeake Drive•Redwood City,CA 94 415)364 9600 L) 18939 120th Ave,N E,Suite 101 •Bothell,WA 98011•( 1-9200 t�' <br /> ❑ 819 Striker Ave,Suite 8•Sacramento,CA 95834•(916)921-9600 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99206• 4-9200'�j" <br /> 'UNOCAL (D - <br /> ❑ 404 N Wiget Lane•Walnut Creek,CA 94598•(510)986 9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)6249800 <br /> Consultant Company G )= X�Fcx.n ie!!i, c- Z$oC tel ' Project Name Fart,�e✓ �n C.� $,S 40- .0 �L <br /> x <br /> Address b���/ �dr�q Cdr+' , - ��'�- �• UNOCAL Project Manager <br /> City el�t c�/c 0 State Cs? Zip Code 9V X'K8 AFE# <br /> Telephone(9ZJ) �57rl -S�S-~� FAX /'ZS, - Site #, City, State 3 Q,[ i . Jr(-"CA4U <br /> Report To n r ` Sam ler 7 QC Data Level D(Standard) ❑ Level C L11 Level B ❑ Level A <br /> � <br /> tL <br /> Turnaround A10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water JAnalyses Requested <br /> Time. ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours <br /> Waste Water <br /> CODE: ❑ Misc Ell Detect ❑ Eval ❑ Remed L) Demol ❑ Closure ❑ Other I <br /> Client Date/Time Matrix # of Cont Laboratorybb <br /> Desc Cont Type Sample# � 1l� �� Comments <br /> Sample i D Sampled p <br /> T$-tb6 Zz o I Va t T o <br /> 2 IJ /l:f 'N � If1 a tr � S'/ ' 0 <br /> i <br /> 3 U Z lb. 0,fkr t K XS4 lit! <br /> 0 <br /> } <br /> 6 <br /> 7 <br /> 8 <br /> 9 �. <br /> 4 <br /> 10 <br /> 0 <br /> ct3 <br /> Relinquished By Date6 Z Time.l;�}� Received B Date Time <br /> Relinquished By Date Time Received B yy�� �� Date Time <br /> Relinquished B Date Time Received B Lab o�/Yt'�. r'�`� Date & ZZ Time <br /> Were Samples Received in Good Condi ❑Yes O No Samples on Ice? r, Yes rJ No Method of Shipment Page_of_ <br /> To be completed upon receipt o -report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes JNo If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes❑ No If no, what was the turnaround time? <br /> f! r Approved by -----Signature _____ _ _-Company — Date <br />