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Chevron California a i • • RequestlChainofCustody <br /> Lancaster Laboratories r � For l a er b rotor s us oly <br /> Acct.M /� Sample#: I SCR#: l I SCS Q <br /> +V0xreqjaYfyisasdence. <br /> Analyses Requested <br /> Facility#: 761 Matrix Preservation Codes Preservative Codes <br /> H=HCl T=Thiosulfate <br /> Site Address: ,4 _ N=HNO3 B=NaOH <br /> Chevron PM: �d/g �L �� Lead Consultant: Sellce <br /> S=H2SO4 O=Other <br /> _� K <br /> ConsultantlOffice: 3iv�? /C�GG�/d / fT�•I4Q ti4.u�4u tcs24c^a£ cs�! 9561 W ❑ c� �° O J value reporting needed <br /> �� o 0- m N ty ❑Must meet lowest detection limits <br /> Consultant Prj.Mgr.: ��� ,e � a z o $ in possible for 8260 compounds <br /> ❑❑ U ❑ ❑ ❑ <br /> Consultant Phone* I/6-Sd>`-oyUo Fax#: 8 0 N 8021 MTBE Confirmation <br /> k ar ❑Confirm highest hit by 8260 <br /> Sampler: /,SL,dtJ/C s/,l [E' <br /> ❑ w $ $ C = do <br /> E m ❑ p Confirm all hits by 8260 <br /> Service Order#: 'I.27 fle2`] ❑Non SAR: ¢ z 2 <br /> ..Date _� ..__:�Time._, 0 .. aRun oxy s on highest hit <br /> I.o _ o ❑Run_oxysonalFhils -..Sam le Identification Collected Collected O v� O m F_ m <br /> W— /Q- -G! /353 bC { bC Comments!Remarks <br /> W4_ Val <br /> w• 7 Xx <br /> V y b( <br /> Relinquished try: Date Time Received by: Date Time <br /> Turnaround Time Requested (TAT)(please circle) -to-'o I 1 l duo <br /> ciaiA> 72 hour 48 hour Relinquished byl 0 patqTime Received by: Date e <br /> 24 hour 4 day 5 day U2_ <br /> ,t <br /> Relinquished by: Date Time Received by: Date Time <br /> Data Package Options(please circle if required) <br /> QC Summary Type I—Full Relinquished b mercial Carrier: R ived by: _ Date Time <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed <br /> WIP(RWQCB) UPS FedEx Other - 4) �I <br /> Disk Temperature Upon Receipt C. Custody Seals Intact? Yes No <br /> j Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605.2425 (717)656-2300 3460 Rev.7130/01 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the dient. <br />