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• • s s ' - • • ""' • ' - • - • • • • <br /> LancasterLaboratories / For Lancaster Laboratories use only I �j 4/ <br /> l�RierequalKyisascieAcct.#: O LJ Sample#: 4/0 Z I Z S 7- 7A SCR#: r S �� <br /> Analyses RequestedU 9 <br /> Facility#: Matrix Preservation Codes Preservative Codes <br /> H=HCI T=Thiosulfate <br /> Site Address: L3I sd" v. +� i N=HNO3 B=NaOH <br /> Chevron PM: � �° �,G Lead Consultant:�!Sg(0.Q- y S=1-12SO4 O=Other <br /> w ❑ [IJ value reporting needed <br /> Consultant/Office:'7/C_��,��r, Q�- s,'kij(p Cto 4 CA 7 M o <br /> 'nn o a :° o ❑Must meet lowest detection limits <br /> Consultant Prj.Mgr.: �`� [mss.S�/ U A possible for 8260 compounds <br /> Consultant Phone#: /h'531,E-1�4cw Fax#: 9/Js- /-Oy3c� o gcli <br /> ix oW u 8021 MTBE Confirmation <br /> U ❑ C' e ❑Confirm highest hit by 8260 <br /> Sampler: rr r/�"�e- .0 <br /> �r o o <br /> rte' E md ❑ El Confirm all hits by 8260 <br /> Service Order#: E]Non SAR: o ¢ z j � F N <br /> ❑ <br /> E _ El @ X $ -2 O Run_oxy s on highest hit <br /> Date Time m o o m = o UJ a a 8 �"' ❑Run_oxy s on all hits <br /> Sample Identification Collected Collected 0 v (1) O m F- 0 <br /> NW-8 0 v Comments/Remarks <br /> 31 <br /> 0A17 MfbE;i PA10iPF- <br /> 0--01 A a J 04v-.-v 1. <br /> Relinquished by: pate jime Recaivgd . Date Time <br /> Turnaround Time Requested(TAT)(please circle) <br /> ST .TAT 72 hour 48 hour linquished byj Date Time Re ived by: Date Time <br /> 4 hour 4 day 5 day <br /> Data Package Options(please circle if required) Rqui ed by: Date Time Received by: Date Time <br /> QC Summary Type I—Full <br /> Type VI(Raw Data) El Coelt Deliverable not needed Relinquished b ercial Carrier: Re i ed by: ate Time <br /> WIP(RWQCB) UPS FedEx Other <br /> Disk Temperature Upon Receipt Co Custody Seals In"c Yes N <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 3460 Rev.7/30/01 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />