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-e,68p Chesapeake Drive•Redwood City CAW(916) <br /> (415)364 9600 ❑ 18939 120th Ave N E,Suite 101 •Bothell,WA 980116)481-9200 <br /> UAcAL . -1819 Striker Ave,Suite 8•Sacramento,CA 921 9600 a East i 1115 Montgomery,Suite B•Spokane,WA 9920 9)924-9200 <br /> j 404 N Wiget Lane•Walnut Creek,CA 94598•(510)988 9600 ❑ 15055 5 W Sequoia Pkwy Suite 110•Portland,OR 97222•(503)624 9800 <br /> Consultant Company ��y , G• V) Project Name <br /> Address �1 / C�kv CG 14 19 I?V6 UNOCAL Project Manager rsC'� '6'-11LS1 <br /> City t y)�J' CV C�2ve.State Zip Code �� ��- AFE# <br /> r <br /> Telephone ` C� FAX# l �- �� )317 Site #, City, State � 1 7G7 !� ' U <br /> Report To <br /> sull'e— C4,/ '- `� Sam ler 1 L-i'` OC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaroundo Work Days J 5 Work Days ❑ 3 Work Days J Drinking Water [Analyses Requested S a G� a <br /> Time ❑ 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours ❑ Waste Water ` v <br /> CODE ❑ Misc ❑ Detect ❑ Eval -41Remed ❑ Demol ❑ Closure ❑ Other r ¢ <br /> Client Date/Time Matrix #of Cont Laboratory l� <br /> Sample I D Sampled Desc Cont Type Sample# �1� Comments <br /> 2 517-fA1 GU �- <br /> Il, �iti_ - J <br /> 4 0 <br /> m <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 0 <br /> 10 1 2 <br /> 0 <br /> co <br /> Relinquished B �—� Dated -c Time l ,s Received B 2'�-- Date Time11.11-9 <br /> Relinquished By Da �l/ Time Received By Date Time <br /> Relinquished B Date�� Time Received 8 Lab �' Date �a� Time •2 / <br /> Were Samples Received in Good Condition? 'Yes.J No Samples on Ice? Q Yes�No Met d of Shipment 67,I) 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? Q Yes❑ No If no, what was the turnaround time? <br /> Approved by Signature Company Date <br />