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O 680 Chesapeake Drive•Redwood City,CA 94015)364-9600 Q 18939 120th Ave,N E,Suite 101 •Bothell,WA 98011 •*81-9200 <br /> ❑ 819 Striker Ave,Suite 8•Sacramento,CA 95 (916)921-9600 Q East 11115 Montgomery,Suite B•Spokane,WA 99206• 24-9200 <br /> -UNAAL Q <br /> �.� <br /> y ❑ 1900 Sates Ave,Suite LM•Concord,CA 945 510)686-9600 Cl 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> 7 RW <br /> ,CompanyName1 ! r Project Name 7�� c) A/`!L^2 <br /> Address 3 y `/ / ( {�� j) ,/9' ,C /G UNOCAL Project Manager Zk <br /> City pMatel Zip ;'-'(�/� Release# <br /> 'i - J�G'G FAX# l�(: ��% Slte# <br /> Telephone f/�; T ' v <br /> Report To `, �^ r <br /> Is- <br /> am ler ,'' �/•t QC Data bevel D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround 1:11 0Work Das 1:15 Work Das ❑ 3 Work Da <br /> YY Ys ❑ Dunking Water JAnalyses Re uested <br /> Time 1:12 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Date/Time Matrix #of Cont Laboratory 1 <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> 0 <br /> ,J <br /> 3 ' <br /> 4 - } <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 0 <br /> 10 <br /> 0 <br /> ro <br /> Relinquished By <br /> Da F� Time (V.pm Received B �'�iczrc Date Time <br /> 1 <br /> Relinquished By (1,� C r Date 7,! L-Time /D5/ Received B /r Date Time <br /> Rehn wished B .1 '� Date /��� Time c Received B Lab (� �=` , Date Time t l` <br /> ' 1 <br /> Were Samples Received in Good Co ition?4�Yes❑ No Samples on Ice? ❑YesaKo Method of Shipment �/� Page of 1 <br /> V e completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes a No If no,what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes a No 1f no,what was the turnaround time? <br /> Date <br /> pp Y <br /> Approved b Signature Company *- <br />