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ARCO Pr is Company ;; Chaff Custody <br /> ow AllanticRichrleWCompany Task Order No <br /> ARCO Facility no City L <br /> anager p,�/� Q Laborato ame <br /> (Facility) -r7oK r'� nt ��7�/ w <br /> ARCO engineer Tele ho a no C Telephone nq� Fax no / ' r� , �-�'1 f <br /> g �b� /� ARCO �d Z9�-��7 nt l`' �� l� Consulta+tf ��� `�-d 1 �� Contract number <br /> Consultant na a I Address J�r, <br /> Consultant 'l/.�S /vi �/1 C. ,(�`yf' r �c�r✓ J � � <br /> ❑ Method of shipment <br /> Matrix Preservation � ^ E� <br /> m m .'_'❑ ❑ nEl <br /> cR <br /> x ©V <br /> CL °c m Soil Water Other Ice Aad a a CL <br /> 8❑ �! m 8 ❑ [� <br /> ►, <br /> E o a a �m xc . t CL 0 � 9r <br /> rA U co w mw �0 O4 �w w w w � � A <br /> -25 �,( )H� l-i Special detection <br /> M-w l /. Z / ! 'C 7 01 � umlur9 Ing <br /> 7Z �-s�� <br /> r►tivl �' � o S'v�'P� %P�'G <br /> nl�w 3,/ I1 /a � <br /> A1v -� ,47 /607 Special QAIQC <br /> CIO Y/17 <br /> /yzo <br /> /kt.r-10 -7 7 f702 Remarks <br /> CY.Dr <br /> Lab number <br /> ,�y <br /> Turnaround time <br /> Priority Rush <br /> I Business Day ❑ <br /> Condition of sample J Temperature received <br /> Rush <br /> R quissampler Date Tlme Received by 2 Business Days El y <br /> w �y t 3 69117 r ys <br /> Relinqu+shed by Date Time Received by Expedited <br /> 5 Business Days D <br /> Relinquished by Date Time R e ed by laboratory Date Time Standard <br /> 3— � r 4�D to Busm Days <br /> Distribut on white copy—Laboratory, Canary copy—ARCO Environmental Engineering Pink copy— nsultant <br /> APC 3292(2 91) <br />