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Chevron Califomia Region Analysis RequestlChain of Custody i <br /> A&Lancaster Laboratories ForAll <br /> IF 1M1E► caster Labor it es u only <br /> eq-" gISaS X-e e !� # � � Sample# yy.--�� <br /> _LL4 7�M' 0 SCR# <br /> Analyses Requested <br /> Facility# — Matrix Preservation Codes Preservative Codes <br /> Site Address H=HCl T=Thiosuifate <br /> CL <br /> N=HNO3 8=NaOH <br /> Chevron PM Lead Consultant 2 S=H2SO4 0=Other <br /> a <br /> Consultant/Officea o ❑ ❑J value reporting needed <br /> Consultant Pri Mg a. z o ©Must meet lowest detection limits <br /> possible for 8260 compounds <br /> Consultant Phon Fax ) ©� o © 0 8021 MTBE Confirmation <br /> Sampler _ __ _ ❑ w o o c ti ❑Confirm highest hit by 8260 <br /> Service Order# ❑Non SAR o L a = M M 9 C ❑Confirm all hits by 8280 <br /> Q _ a? ❑ + m z ti ❑Run_oxy s on highest hit <br /> Date Time m E _ K g <br /> Sam le Identification Collected Collected d p Run,oxy s on all hits <br /> l r <br /> i <br /> Comments!Remarks <br /> �yu�r <br /> I r r � k y <br /> S ' r <br /> (12 <br /> p t <br /> - l <br /> e eceived <br /> Turnaround Time Requested(TAT)(please circle) at Time Rby Date Time <br /> STD TA 72 hour 48 hour 4 day 5 day <br /> 24 hour Dat Time Received by Date Time <br /> Data Package Options(please circle if required) Relinquished by Date Time Received by ate Time <br /> QC Summary Type I—Full <br /> Type V!(Raw Data Relinquished ercial Carrier <br /> ❑Coelt Deliverable not needed ived by Date Time <br /> WIP(RWQCB) UPS FedEx Other10±j V .1 L,'�Plj AAN 00 ..-- n ' <br /> p�- <br /> Disk Temperature Upon Receipt , C. Custody Seal In ct? Yes N <br /> I !I <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,P 12425,Lancaster,PA 17605-2425 (717)656-2300 Rev 7130101 <br /> Copies White and yellow should accompany samples to Lanc�aboratones The pink copy should be retained by the client. <br />