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w . <br /> AM= MAW <br /> i <br /> For <br /> 1u]Ler�� �#1 Q�CA/ Lancaster Laboratories use only � �/ �, <br /> Acct # t�� Sample# <br /> yV}�e quality is asae►rce c� <br /> X21 J ` Analyses Requested <br /> z It 1/y <br /> U� Preservation Codes Preservative Codes <br /> Facility# H=HCl T=Thiosulfate <br /> CL NSite Address tet^ =HNOa B=NaOH <br /> S=1-12SO4 0=Other <br /> Chevron PM �� *r.,, Lead Consultant <br /> 4) <br /> 4) ❑ J value reporting needed <br /> GonsultanVOf6ce a N ❑Must meet lowest detection lands <br /> c C3 possible for 8260 compounds <br /> 10 <br /> Consultant Pr) Mgr _ /4, T. ner- -- ci ® ❑ ❑ <br /> Fax# Qf O 3 0 Fax <br /> MTBE Confirmation <br /> Phone# I *- m a .r ❑Confirm highest hit by 8260 <br /> Sampler t A v�"' m E m g tg W ❑Confirm all hits by 8260 <br /> ❑Non 5AR �' y <br /> Service Order# X $ o ❑Run oxy s on highest hit <br /> Field Repeat Top Time New m a o x Y C]Run oxy s on all hits <br /> Porn Name Matrix Sam le De th Year Month Da ilected Field Pt °O J Comments!Remarks <br /> I 4 TOO <br /> 414 <br /> r , <br /> 10 <br /> Ifoo <br /> wished by at Time Re by qD to Time <br /> Tumaround Ttme Requested(TAT)(please circle) d <br /> TD TAT 72 hour 48 hour Relin s d by <br /> e Time Recenred 'y Date Time <br /> 2 4 day 5 day <br /> ehnquishe by Date Time Received by F068, <br /> te Time <br /> Data Package Options(please circle if required) <br /> QC Summary Type I-Full Relinquished by Comm rner Received by te Time <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed UP ed o Other ��� �r es <br /> Disk(RWQCB) Custod Seals Intact? Yes No <br /> Disk Temperature Upon Receipt C. Y <br /> 3460 Rev 10104101 <br /> Lancaster Laboratones,Inc 2425 New Holland Pike PO Box 12425 Lancaster,PA 17605-2425 (717)656.2300 <br /> Copies White and yellow should accompany samples to Lancaster Laboratones The pmk copy should be retained by the client <br />