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O 680 Chesapeake Drive•Redwood City,CA 94015)364-9600 0 18939 120th Ave.,N.E.,Suite 101 •Bothell,WA 98011 •( 81-9200 <br /> 0819 Striker Ave.,Suite 8•Sacramento,CA 95834•(916)921-9600 O East 11115 Montgomery,Suite B•Spokane,WA 99206•(5924-9200 <br /> UNOCAL ❑ 404 N.Wiget Lane•Walnut Creek,CA 94598•(510)988-9600 © 15055 S.W.Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Consultant Company: A9�� Project Name: <br /> ��I " Q f <br /> Address: UNOCAL Project Manager. ^� <br /> City: Stater Zip Code: AFE#: <br /> o �.1 °? <br /> Telephone: � '/'�. FAX#: �� Site#, City, State: � V <br /> Report To: 1,+6 /� am Sam ler: 1 <br /> � �V ZXAbM QC Data: ❑ Level D standard ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround ❑ 10 Work Das ❑ 5 Work Das ❑ 3 Work Das a_ <br /> Y Y Y ❑ Drinking Water [Analyses Re uested ' <br /> Time: Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water ,y,u <br /> CODE: ❑ Misc. ❑ Detect. ❑ Eval. ❑ Remed. ❑ Demol. ❑ Closure ❑ Other V <br /> 1 <br /> Client Date/Time Matrix #of .Cont. Laboratory V <br /> Sample I.D. Sampled Desc. Cont. Type Sample# Comments <br /> 5331, tr -b3 6 <br /> 2.,S-,3 0 <br /> 3. G <br /> 3 � 3 <br /> 4. o <br /> 5. <br /> !930gist-p <br /> 7. C 1AA 1-PL <br /> a. <br /> 9. <br /> 10 ° <br /> L <br /> O <br /> Relinquished B Date: Time Received B : - Date: Ffi> Time: y6 <br /> a� <br /> Relinquished By: Dale: f' PP Time/0 Received B : ZEDate: Time: t <br /> Relinquished BY: Date: Time: Received B Lab: Date. Q Time: <br /> Were Samples Received in Good Condition?❑Yes O No Samples on Ice? ❑Yes Q No Method of Shipment Page,of <br /> To Se completed.upon receipt of report: <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes t]No 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 /> Approved by: Signature: Company: Date: <br />