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I <br /> 2 680 Chesapeake Drive•Redwood City,CA 940 15)364-9600 ❑ 18939 120th Ave,N E,Suite 101 *Bothell,WA 98011 •(20 �$1-9200 » _ <br /> ❑ 819 Striker Ave,Suite 8•Sacramento,CA 958 •(916)921-9640 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99206•( 4-9200 <br /> UNOCAL <br /> ❑ 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686 9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Porl€and,OR 97222•(503)624-9800 <br /> Company Name 6Los rva Les �Tl ,/ a w L Protect Name V'!9 L-.J-- , l� <br /> Address �1�y yK �/ eVO <br /> UNOCAL Project Manager ci ,5TGv) <br /> City �e� ova State Zip Code Release# <br /> Telephone <br /> site# 0l70 7 �i L <br /> Re ort To <br /> 6vcGL�vsS Sam ler 1 G�J OC Data vel D (Standard) ❑ Level C ❑ Level B ❑ Level A c <br /> Turnaround ❑ 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water lAnalyses Requested <br /> Time. ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water �,� j { 2� <br /> 4 CODE: ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demo1 ❑ Closure ❑ Other `s { <br /> Client DatelTime Matrix #of Cont Laboratory <br /> Comments � <br /> Sample I D Sampled Desc Cont Type Sample# <br /> 1 -7V14IZ-+✓y�7 �r- ! ,y �I <br /> 0 <br /> 2 Ar OZ <br /> 3 <br /> 3 <br /> 0 <br /> 4 <br /> m <br /> } <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 Z <br /> 0 <br /> 10 <br /> 0 <br /> co <br /> Relinquished By Date IZ 97 Time Received B Date .' <br /> Relinquished By ate Time Received By Date Time -E <br /> t2-/z.(f�1 <br /> Relinquished By I Date iTime 1 Received By Lab Date Time rr <br /> Were Samples Received in Good Condition? es❑No Samples on Ice? 1:7 YesX/No Method of Shipment 6d Page_I of <br /> 1 <br /> To be completed upon receipt of report <br /> i) Were the analyses requested on the Chain of Custody reported? El Yes❑No If no,what analyses are still needed? <br /> 2) Was the reporE issued within the requested turnaround time? d Yes�NoIf no, �h �eurnaroundtime? �Date <br /> proved by Signature any <br />