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Iq <br /> x'680 Chesapeake Drive•Redwood City,CA 94063 364.-9600 d 16939120th Ave.,N.E.,-Wte 101.8othelt,WA 98011•(206) 20U <br /> UNOtHLOOl 0 819 Striker Ave.,Sults 8-Sacramento,CA 9583 4- 6)921-9600 ❑ East 11115 Montgomery,Suite 8-Spokane,WA 99206-(509) 9200 900 Bates Ave.,Suite LM-Concord,CA 94520-(510)686-9600 0 15055 S.W.Sequoia Pkwy,Site 110-Portland,OR 97222-(503)624-9800 <br /> r A <br /> Company Name: rC Z54u)fUL]W 1 U Project Name: L_.0 �0Ctt! 4YO. 130 NOW 078 <br /> Address: G (,� Oct( p SU f Wo- UNOCAL Project Manager: ~t i <br /> City:SCI �lP State: CJ9 Zip Code: ���iU Release#: 6— 004,03 <br /> FAX#: `7—'T/ Site #: g o <br /> Telephone: v <br /> 1 � <br /> ,Report To: C� iSampler: Geo eve QC Data: —A(Standard) ❑ Level B C2Level C ❑ Level D c <br /> a. <br /> Turnaround Working Days ❑ 2 Working Dap, ❑ Drinking Water JAnalyses Re uested <br /> Time: ❑ 5 Working Days ❑ 24 Hours ❑ Waste Water <br /> ❑ 3 Working Days ❑ 2-8 Hours 9-6ther <br /> Client Date/Time Matrix #of Cont. Laboratory <br /> Sample I.D. Sampled Desc. Cont. Type Sample# �C Comments <br /> all <br /> q L <br /> z.rpa -1� x ° <br /> ._� 5: <br /> K + <br /> 3rP-5 <br /> 4.ra _1-> �c <br /> 5. <br /> 7. <br /> f3. <br /> 9 � <br /> • o <br /> 10. <br /> • o <br /> Relinquished By: / Date: Tfine: ��� Received B : Date- 3 f Time: <br /> /�/�� f m <br /> Relinquished By: <br /> Date Time: Received B 4� <br /> Date: Time: <br /> Relinquished l3 : Date' Time://, Deceived B Lab: Date* ' Time: <br /> Were Samples Received in Good Con Wil n?AYes O No Samples on Ice? Yes❑ No Method of Shipment Page of <br /> To be corripfeled upon receipt of report: i <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes 0 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 />