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• • • • - • A • • - • • famror <br /> All <br /> Lancaster Laboratories Acct # For�`` t y 53��S1�14 SCR# <br /> �.P Sample# �'3 <br /> Where qualrtys a science. <br /> GS8 05 P --�� Analyses Requested <br /> C� Matrix Preservation Codes Preservative Codes <br /> Facility# h�v ro LA SS f— -8 -'>1 H=HCI T=Thiosulfate <br /> Site Address Sit�w�Yr�a -tet ���'�-��?� a n N=HNO3 B=NaOH <br /> Chevron PM _<_G 11V'r—tri Lead Consultant 7Ir <br /> S=H2504 O=Other <br /> �!/ - m N CD ❑J value reporting needed <br /> Consultant/Office ��x cin l n C• a s 5 <br /> JJ�� i3 x ❑Must meet kw4est detection limits <br /> Consultant Pit Mgr !-)C C%n n4 ��Gv` �+ � a z o � �, possible for 8260 compounds <br /> ❑❑ U ❑ ❑ Da <br /> Consultant Ph # tS �J�� 7Z Ste' Fax#' Zt a g © 6021 MTBE Confirmation <br /> Sam ler vs m ❑ W &I o � " ©Confirm highest hit by 8260 <br /> p " E m $ ❑ <br /> ri <br /> _ ❑Confi--rm all hits b <br /> 8260W aService Order# Non SAR n o + ❑Run os on highest <br /> st h <br /> d� QDate Time o Run oxy s on all hitsColleced Collected 9 OZmSam le Identification co <br /> A VComments!Remarks <br /> !AW-6D SPY/o-Z 15-'Vo X <br /> Relinquished �l to Time Date Time <br /> Turnaround Time Requested(TAT)(please circle) /` J rj �� 9 , <br /> 5TD T 72 hour 48 hour MQlIr;qqu1[sh�d- <br /> at Ti e R iv d b Date Trime24 hour 4 day 5 day 1 Date Time Recei d by Date Time <br /> Data Package Options(please circle if required)QC Summa ypeType VI(Raw Data} ❑Coelt Deiivlarabie not needed Commercial Carrs / Recei D}ate} Ti e <br /> WIP(RWQCB) UPS FedEx ther ^]bLIN S/!b <br /> bz <br /> Disk Temperature Upon Receipt C. Custody eats Intact? Yes No <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17805-2425 (717)656-2300 3460 Rev 7130101 <br /> Copies White and yellow should accompany samples to Lancaster Laboratories The pink copy should be retained by the client <br />