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�Lancwter[ a}r, r&fl 1C rO For La caAte 0� cries�y_$e�,only SCR# <br /> 1M����yisascwlce A # lP Sample# �S 'C <br /> 6 X-* �ro 6,c -:165-8 O 517 0 Analyses Requested <br /> Facility# 3 Matrix Preservation Codes Preservative Codes <br /> Site Address ry H=HCI T=Thiosulfate <br /> CL N =HNO3 B=NaOH <br /> Chevron PM c yc, Lead Consultant [r' � <br /> to <br /> S=H2SO4 O=Other <br /> �CC/ _ m �� ❑J value reporting needed <br /> Consultant/OfficeYr X�.-E ,��C• .0o � � <br /> Dc <br /> f�� ) r � 8 X ❑Must meet lowest detection limits <br /> Consultant Pry Mgr DcCA r►nC4 r�Gv� mr � U 0 r possible for 8260 compounds <br /> Consultant Phan # vS $�✓��� S Fax# ��' o °� N8021 MTBE Confirmation <br /> Sampler y ❑ 4) m o a ❑Confirm highest hit by 8260 <br /> Service Order# ❑Non SAR o Q Z _� � ❑Confirm all hits by 8260 <br /> CL m + ` ❑Run_oxy s on highest hit <br /> Date Time E o in oSam le Identification Collected Collected 1215 <br /> �- ❑Run ,oxy s on all hits <br /> Comments!Remarks <br /> Relinquished D to Time Time <br /> Turnaround Time Requested(TAT)(please circle) J 54i/Q.'? <br /> aR <br /> STD T 72 hour 48 hour R at 04 <br /> Re iv d b Date Time <br /> 24 hour 4 day 5 day �+'vC� <br /> Data Package Options(please circle if required) R nq fished b Date Time Recei by Date Time <br /> 3 ,r ,rrsLng <br /> QC Summary Type I—Full Relinquished by Commercial Carri Receiv im <br /> Date Te <br /> Type V1(Raw Data) E]Coelt Deliverable not needed )K� {c/ <br /> UPS FedEx ther ^l S!!o <br /> WIP(RWQCB) <br /> Disk Temperature Upon Receipt C. Custody&eals Intact? Yes No <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 3460 Rev 7130101 <br /> Copies White and yellow should accompany samples to Lancaster Laboratones The pink copy should be retained by the client <br />