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EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0019458
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FIELD DOCUMENTS
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Last modified
6/18/2019 3:01:28 PM
Creation date
6/18/2019 2:42:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0019458
PE
2951
FACILITY_ID
FA0004531
FACILITY_NAME
LLNL-SITE 300 BLDG 834 & 871
STREET_NUMBER
0
STREET_NAME
CORRAL HOLLOW
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
CORRAL HOLLOW RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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Chain-of-Custody Record and Anaiytfc Instructions Page of � B 0 0 0 7 3 . <br /> Send all results and invoices to: <br /> Field Log Book#(COC#) Release# <br /> M. Heaton, is <br /> 11 01% LLNL Acct.#(please fill in and circle) Sampling Re uest# <br /> 11R all D <br /> Attn: ORAD Data Management Team L-633 Analytical Laboratory Name S <br /> Lawrence Livermore National Laboratory Analytical Laboratory Log# <br /> P.O. Box 808, Livermore, CA 94550 <br /> Analysis &Turnaround Additional Instructions to Lab <br /> Also Fax copies to: Fax# Required 1 <br /> Project Name: 4 . <br /> Sampled By : Sampler's Employer: <br /> Sam le Matrix/T e <br /> Gri�7 <br /> P Sample YP 2 #of Stury <br /> Identification Date/Time Container/Type 3 Cont. Are Remarks <br /> 75o f-(9 -t 2 <br /> I � <br /> $igFrature <br /> Company T me _ Date 1. N=normal turnaround, F= 1-week turnaround <br /> Relinquished by i I R=24-hour turnaround,H=Hold do not analyze unless requested <br /> Received by ,� <br /> �� 3 S 7 2. Sample Matrix Codes:See list on back of pink copy <br /> Relinquished by 3. Container type codes: V=VOA Bottle,P=Plastic Bottle, <br /> Received by G=Glass Bottle,T=Brass Tube, <br /> B=Bag,S=Stainless Steel Tube, <br /> Relinquished by <br /> O=Other(specify under remarks) <br /> i <br /> "Y Internal Use Only <br /> Received by 1 <br /> Revision 3.3 White:Laboratory return to ORAD Pink:Sampler leaves with ORAD <br /> - Attn.Data Mana ement Team 1-633 Yellow:1.Analylica l.;o) 1ttn.ORAD Data Management Team 1-633 <br /> ..9 Oct. )�ORAD g <br />
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