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i ❑ seo Chesapeake Drive•Redwood Ckry.CA E, _ . <br /> 15)364-9&00 Q 18939120th Ave.,N.E.,Suite tot 01301hell,WA 9801'. 81-9200- <br /> UNA L ❑819 Striker Ave.,Suite 8•Sacramento,CA 958316)921-9600 Q East 11115 Montgomery,Suite 13•Spokane,WA 992 <br /> po OB•(509)924-9200 <br /> O 404 N.Wiget Lane•Walnut Creek,CA 94596•(510)988-9600 ❑ 15055 S.W.Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Consultant Company: <br /> Project Name: C f/—0/ <br /> , <br /> Address: 113 15 UNOCAL Project Manager: <br /> City: � �"� <br /> ,4 State: Zip Code: 9 AFE#: <br /> Telephone: ��(p ' c3 FAX #: gS&' z-035�7. <br /> Site #, City,.State: <br /> Re ortTo: 1� / i✓f,� Sam ler L L(/ QC Data: ❑ Level D(Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround ❑ 10 Work Days ❑ 5 Work Days ❑ 3 Work DaL <br /> Ys ❑ Drinking Water Anal ses Re uested iL <br /> Time: 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours <br /> ❑ Waste Water n <br /> CODE: ❑ Misc. ❑ Detect. ❑ Eval. ❑ Remed. ❑ Demol.❑ Closure ❑ Other Q <br /> Client Date/Time Matrix # of Cont. 'r <br /> Laboratory <br /> Sample I.D. Sampled Desc. Cont. Type Sample# <br /> Comments <br /> 4 �r 3 <br /> m <br /> 6. } <br /> 7 <br /> 8 <br /> f0. � <br /> a <br /> 0 <br /> Relinquished By: te: r1 Time � Received B Date: Time: <br /> Relinquished B : <br /> q Y Date: P Y Time• Received B Date: <br /> Relinquished B Date: Time: Received By <br /> Lab: <br /> Data: rnme: <br /> Were Samples Received In Good Condition?0 Yes 0 No Samples on Ice? O Yes Cl No. Method of Shipment <br /> Page of_ <br /> To Be completed upon receipt of report: <br /> 1) Were the analyses requested on the Chain of Custody reported? 0 Yes Cl No If no,what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time?-.a Yes O No It no,what was the turnaround time? <br /> Approved by: Signature: Company: <br /> Date: ,- <br />