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awl MOOR V0178 A --Q�=rfrojg go <br /> Lancaster Laboratories f�Ci For La ca to boratories %9 only <br /> Acct # O(P Sample# T 1 ��� ' _ SCR# <br /> �VOwe quality is a saence <br /> OS 17 02 Analyses Requested <br /> vto Matrix Preservation Codes Preservative Codes <br /> Facility# �*h/��r ss 1` 3rd 3�r� H=HCI T=Thiosulfate <br /> Site Address �f�by S�,C.��w�yr�a .tet tic _�� a n N=HNO3 B=NaOH <br /> Chevron PM <cc kyr—" Lead Consultant V" 5=H2SO4 0=Other <br /> Consultant/Office 4!5:;-e A/C ` !�X�.� y ri C @ wo c �� ❑J value reporting needed <br /> f 1 ( ;4 [1 Must meet lowest detection limits <br /> Consultant Prl Mgr r--CCcr)nCf �7�+^ Qin A U Q ) possible for 8260 compounds <br /> Consultant Phon # tS 5"5�` 5S` Fax# zt� o a o �c 8021 MTBE Confirmation <br /> � N <br /> R ❑Confirm highest hit by 8260 <br /> Sampler �., ❑ w $ $ C <br /> N E Co 2 ❑ ❑Confirm all hits by 8260 <br /> Service Order# []Non SAR o Q z 5 <br /> CL y } ; ❑Run oxy s on highest hit <br /> Date Timeoo _ o <br /> Sample Identification Collected Collected 0U rn 3 O 12 ©Run oxy s on all hits <br /> S a,1 Q a Comments!Remarks <br /> W <br /> -6D .� fY a� 15 10 X <br /> JAM 111 A I <br /> Relinquished Dote Time c Date Time <br /> � <br /> Tumaround Time Requested(TAT)(please circle) �� j 5/1 V © d <br /> STD T 72 hour 48 hour R at Ti�mye Re ry d b Date Time <br /> 24 hour 4 day 5 day ( ! - I" <br /> R nq fished 14 Date Time Receiv d by Date Time <br /> Data Package Options(please circle If required) <br /> QC Summary Type I—Full Relinquished by Commercial Cam Recery Date TirBe <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed L C)m <br /> UPS FedEx ther ^l J/! <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 Laboratories The pink copy should be retained by the client <br />