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O fi60 Chesapeake Drive•Redwood City,CA 6 415)364-9600 ❑ 16939 12016 Ave.,N.E..Suite 101• + <br /> U N&A L Bothell.WA 9aor, 0481-8200 <br /> I U 819 Striker Ave.,Suite a•Sacramento,CA 951'3 916)921-9600 O East 11115 Montgomery,Suite B•Spokane,WA 99206• <br /> Po {509)924-9200 <br /> ❑ 404 N.Most Lane•Walnut Creek,CA 94598•(510)988-9600 ❑ 15055 S.W.Sequoia Pkwy,Suite 110•Poriland,OR 97222•(503)624-9800 <br /> Consultant Company: T Project Name: ® 1 <br /> Address: <br /> UNOCAL Project Manager: <br /> City: State: Zip Code: AFE <br /> Tele hone: FAX#; <br /> Q t7�d' Site#,City, State: Q LD <br /> Re ort To: U . <br /> Turnaround ❑ 10 Work Days ❑ 5 Work Days Ll 3 Work DaOC Data: ❑ Level D(standard) ❑ Level C ❑ Level B ❑ Level A <br /> Days ❑'Drinking WaterA. Anal ses Requested <br /> Time: Work Das ❑ 1 Work Da C12-8 Hours <br /> ❑ waste water <br /> CODE: ❑ Misc. ❑ Detect. ❑ Eval. ❑ Remed. ❑ Demoi. ❑ Closure ❑ Other <br /> Client Date/Time Matrix #of Cont. <br /> Sample I.D. Sampled Desc. Cont. Type Laboratory <br /> Sample# Comments <br /> �ll.. <br /> b3 <br /> A <br /> � <br /> 5. <br /> 5log 15D <br /> 6. } <br /> S. J <br /> 9. <br /> 0 <br /> 0 <br /> n <br /> Relinquished B Dale-Y, Time Received BY: <br /> • Date y Time: y6 <br /> Relinquished By Date: /0 <br /> . P Time: Received B <br /> Dais: Time: -C <br /> Relinquished By: Date: Time: Received By <br /> Lab: <br /> Date Q` Time: <br /> Were Samples Received in Good Condition?0 Yes 0 No Samples on Ice? 0 Yes Q No Method of Shipment Pa g e_ of,. <br /> h <br /> To be completed upon receipt of report: <br /> 1) Were the analyses requested on the Chain of Custody reported? 0 Yes 0 No If no,what analyses are still needed? <br /> 2) Was the report issued within the'requested turnaround time? ❑Yes 0 No It no,what was the turnaround time? <br /> Approved by: ----- <br /> __ - —------- --- - —Signature: <br /> - ------------_—_Company: ----- <br /> ------_._. •--�Date: <br />