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J 680 Chesapeake Drive•Hedwood Gity,UA Y4 (415)Jba UtUU U Id1J iY ILUth Ave,Nb,butte 1V1 •bOthtsu <br /> ett VVA Sit <br /> UN ALAve, <br /> ❑ 819 Striker Ave,Suite 8•Sacramento,CA 9 •(916)921-9600 ❑ East 11115 Montgomery,Suite B•Spokane WA 99206 )9249200 <br /> • <br /> ❑ 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686 9800 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)1:24-9810 ; <br /> } <br /> Company Name CJ Project Name <br /> Address 3 T-) 1�f G �,�}� �yZ UNOCAL_Project Manager D'J '- <br /> City 'Q 2rLg6v State (7-,A - Zip Cade Release# <br /> c <br /> a� <br /> Telephone FAX# 'I)(- L,3H31'7 Site# U <br /> Repo To �r w� Sam ler �� Q{�u C` QC Data Level D (Standard) ❑ Level C C3Level B ❑ Level A <br /> n. <br /> Turnaround Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water Analyses Requested <br /> Time ❑ 2 Work Das ❑ 1 War Day ❑ 2-8 Hours ❑ Waste Water �rY <br /> CODE: ❑ Misc ❑ Detect ❑ Eval Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Date/Time Matrix #of Cont <br /> Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> al 0 <br /> rL t ti, ° <br /> L <br /> 2 `w -I�7y t gales �- 0 <br /> 3 <br /> 4 2 <br /> 5 <br /> s <br /> 7 <br /> B <br /> 9 <br /> I � <br /> 10I I J H1 <br /> 1 <br /> C7 <br /> [d <br /> Relinquished By - Date ft,-f t Time I�d�r Received B /-,',— Date ;/1 7 f Time ` J <br /> ' ��S Received B Dal /7 Sr Time <br /> Relinquished By Date � g Time � <br /> Relinquished B f Dates l7 S Time U lS Received B (/ab /x ate Time !S <br /> Were Samples Re ved in G od Condition?&'Yes❑ No Samples on Ice? FJYes No Method of Ship ent,(5eagold Page of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes❑ No If no,what analyses are still needed? ------- - - - <br /> 2) Was the report issued within the requested turnaround time? 0 Yes❑ No If no,what was the turnaround time? - --- <br /> Approved by Signature Company Date <br />