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~ U B 19 Striker Ave Suite 8•Sacramento,CA 95834•(9 1 9600 U East 11115 Montgomery,Suite B•Spokane WA 99206 <br /> U N O ry U 404 N Wrgei Lane•Walnut Creek CA 94598•(510)988 9600 U 15055 S W Sequoia Pkwy Suite 110•Portland OR 97222•(503)624 9800 <br /> 1s � <br /> lConsultant i I Project Name f`�f/_ -1q Company <br /> �tI ' ;" / " ti , .1) r l t <br /> Address ? t,5 :Y ' , ti ; ' i( , , t /` ; +E I UNOCAL Project Manager ; II <br /> City { k State Zip Code I j ( s AFE # <br /> Telephone I ( ',, r j 1 I ` .t '-' FAX # r Site #, City, State F 'I`1 <br /> Report To _ i _� t, + I f` ' 1.4+_4� 4,i sampler I QC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A c <br /> Turnaround ❑ 10 Work Days ❑ 5 Work Days ❑ 3 Work Days IJ Drinking Water y� rl At1a1'ses Re nested <br /> Time ❑ 2 Work Das 13 1 Work Da ❑ 2-8 Hours ❑ Waste Water <br /> CODE ❑ Mlsc ❑ Detect ❑ Evai ❑ Remed ❑ Demol ❑ Closure ❑ Other `E- <br /> Client Date/Time Matrix 4 of Cont Laboratory <br /> Comments <br /> Sample I D Sampled Dese Cont Type Sample # <br /> 1 S I f f 1�fE 1 c 0r f Li h t r' S N �J /\ `t� iu <br /> J <br /> 3 <br /> 4 Ir r — <br /> a� <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> g <br /> � o <br /> 10 <br /> { 0 <br /> ca <br /> Relinquished By r ,,, �, /;��"�% Date - �`s� Time 7` fS` Received B -G'� � Date _ Time <br /> Relinquished By �1i�''' Date �:fry, I Tirrle,_' y -_ Received B -- - -�- - W - _ Date Time <br /> _ - I�f <br /> Relinquished B - - Date Time Received B Lab ' �i r Date ` i Time r <br /> Were Samples Received In Good Condition?U Yes Q No Samples on Ice? ❑ Yes Q No Method of Shipm�i}t 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? O Yes U No If no, what was the turnaround lime? - - <br /> roved by Signature — Company - _—Date —_i <br />