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U odu l iiubaPvdKe U11Vt;•he(JWUVU Ully,LH 7iiL'N3•t4 15J.364-`JbW a Ib90V Levin r+ve.,N.t.,SUI to 101 -Bothell,WA 98611 .--16)481-9200 <br /> `" CAL Cil 819 Striker Ave.,Suite 8•Sacramento,CA`<;r�y34•(916)921-9600 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99206—'; )924-9200 <br /> UI�r�J <br /> ❑ 1900 Bales Ave.,Suite LM•Concord,CA 94520•(510)686-9600 ❑ 15055 S.W.Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-OW <br /> Company Name: Project Name'. <br /> o $� <br /> Address: y ise'd e~ A�ovo UNOCAL Project Manager: <br /> City: Awvvot a&:Q2'1'0 State: 00�74. Zip Code: SSB 7r> Release#: <br /> C <br /> m <br /> Telephone: /-/_T00 FAX #: CPO 6J/- /J17 Site#: v <br /> • <br /> Report To: Sam ler: .do 0& r OC Data: 2<evel D(standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround ❑ 10 Work Das CL <br /> Days 05 Work Days ❑ 3 Work Days ❑ Drinking Water JAnalyses Rectuested �. <br /> Time: ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc. ❑ Detect. ❑ Eval. ❑ Remed. ❑ Demol. ❑ Closure ❑ Other Q <br /> Client Date/Time Matrix #of Cont. Laboratory tk ID <br /> Sample <br /> Sample I.D. Sampled Desc. Cont. Type Sample# Comments 4 c CrQ` <br /> 1. r S-iY-f7 S r� a% <br /> W.O. -/- /D / xnxE ,G 3 )4- <br /> 2. <br /> azo t <br /> 2. se. <br /> FC6. <br /> 3 <br /> 4. � <br /> 5. <br /> 6. <br /> 7. <br /> 8. <br /> 9. <br /> 10. O <br /> .. <br /> as <br /> 0 <br /> Relinquished 8y: Date: S-lr Time: /O.SSo Received By: Dated sh- Ime: QSU <br /> Vv <br /> Relinquished B . Date '7 Time: �U s <br /> q �1 Received B : Date: Time: <br /> Relin <br /> Relinciuished B Date: Time: Received By Lab: Dat /7 Ime: 10.6 <br /> ___J <br /> Were Samples Received in Good Condition?�Yes 0 No Samples on Ice? �Yes O No Method of Shipment_ G{(01�1 Page T,•,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? C)Yes❑ No If no,what was the turnaround time? <br /> Approved by: _ _ Signature: ____ _.Company: Date: <br />