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O 660 Chesapeake Drive•Redwood City,CA 940 15)364 9600 O 18939 120th Ave,N E,Suite 101 •Bothell,WA 98011 •{ 1-9200 .J <br /> ❑ 819 Striker Ave,Suite 8•Sacramento,CA 95834•(916),921-9600 ❑ East 114 15 Montgomery,Suite B•Spokane,WA 9b206•(509)924 9200 <br /> VN AL 0 404 N Wiget Lane•Walnut Creek,CA 94598•(510)988-9600 _O 15055 S W Sequoia Pkwy,Suite 110•Portland,OR197222•(503)624-9800 <br /> I <br /> Consultant Company f Project Name 316 077 <br /> Address U �' 14 f 7 4 r Y yU UNOCAL Project Manager Jam A4 <br /> City State /q Zip Code 15'11 J AFE# u S �- <br /> c <br /> Telephone -] eJO FAX# (Y 1 7�3 Site#,City, State ?7 <br /> Re ort To Jt' Irl -)"o Tsampler 6J I'' L'-- QC Data 8i Level D (Standard) ❑ Level C ❑ Level B ❑ Level A c <br /> Turnaround Q 5 Work Das ❑ 3 Work Days Y Y IJ Drinking Water Anal ses Re nested <br /> Time. ❑ 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc ❑ Detect ❑ Eval I-] Remed ❑ Demol ❑ Closure U] Other � <br /> " Client Datefrime Matrix it of Cont Laboratory Q`�` 4� Q` <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> 0 <br /> 2 F ° <br /> cu <br /> 3 <br /> 3 <br /> A O <br /> 5 > <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> 0 <br /> 4 <br /> Ca <br /> � J <br /> Relinquished By �' Date /�%/�7 Time !+S � Received By Date Time , <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished BDate Time Received 13V Lab ,¢ lc C0 Date ITime 1S <br /> Were Samples Received in Good Condition?El Yes El No Samples on Ice? E7 Yes❑ No Method of Shipment Page_of <br /> To be completed upon receipt of report <br /> N 1) Were the analyses requested on the Chain of Custody reported? 0 Yes Q No If no, what analyses are still needed? <br /> `2) Was the report issued within the requested turnaround time? A Yes 0 No If no, what was the turnaround time? <br /> 'op oved by �`�- �l -rte t)Signature L • ��-��r,�r r.r Company �fy—( Date f ; /iI <br />