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Q 680 Chesapeake Drive•Redwood City,CA 94063•(415)364-9600 d 18939 120th Ave N E Suite 101 •Bothell,WA 98011•(206)481-9200 <br /> UNOCALQ 819 Stnker Ave Suite 8•Sacramento,CA 95834•(916)921-9600 East 11115 Montgomery Suite B•Spokane,WA 99206•(509)924 9200 <br /> 0 404 N Wiget Lane•Walnut Creek,CA 94598•(510)988-9600 LI 15055 S W Sequoia Pkwy,Suite 110•Portland OR 97222•(503)624-9600 <br /> Consultant Company G�'TJ u r) 7V(C- Project Name <br /> Address . �,{,�.� lf,,t ,/ j'�yC UNOCAL Project Manager Aj f sic <br /> cityy,Gf'`G (ry State ff Zip Code 7� AFI=# <br /> / 7 � <br /> Telephone f/ - �' '/�/�' FAX# �i� _ll�� Site#, City, State '��=�� -)7G7 /7 yC U <br /> Re artTo <br /> ISampler QC Data— Level D (standard) ❑ Level C ❑ Level B c <br /> Turnaround 14-M Work Days 1:15 Work Days ❑ 3 Work Days ❑ Drinking Water JAnalyses Reques IIOVT1 <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Flours ❑ Waste Water <br /> CODE. ❑ Misc ❑ Detect ❑ Eval W-Remed ❑ Demol ❑ Closure J Other <br /> Client Date/Time Matrix #of Cant Laboratory �)s <br /> Sample I D Sampled Desc Cont Type Sample Comments <br /> 16 <br /> 2 �� It�` l �a Z tea ° <br /> 63 <br /> 4 0 <br /> m <br /> 5 } <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> 0 <br /> Relinquished By —J Date U ,J Time Received B Date D $ vv J <br /> 0 <br /> Relinquished By Date q-7-1.1 Time p bV0 Received By Date Time T �� <br /> Relinquished B Dat � Time Received By Lab Date qb>Ar,Time <br /> Were Samples Received In Good Condition?❑Yes a No Samples on lee? D Yes❑ No Method of Shipme Page 1 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) W the report issued within the requested turnaround time? ❑Yes❑ f no, what was the turnaround time? <br /> '4pprove Signature Company DaTe- <br />