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Chevron Califomia Region Analysis RequestlChain of Custody <br /> l .,,,�.,�{y� �{ �}��•e[ For Lancaster Laboratories use onty <br /> �L i.i�rite as.� b to ws Acct.#:�v� Sample#: L-�(?�2� `S SCR#: <br /> 1. @' <br /> Analyses Requested U�fL <br /> 7 y <br /> t Matrix Preservation Codes Preservative Codes <br /> Facility#Q l y 2 } H=HCl T=Thlosulfate <br /> Site Address: N N=HNO3 B=NaOH <br /> Chevron PM: N Lead Consultant: ! S=H2SO4 O=Other <br /> Cl) c <br /> �t� w ❑ ❑J value reporting needed <br /> Consu ltanVOfflce: 3 tzY rur) �L ail)i �� o <br /> ,A gS1,�10 a° z ❑Must meet lowest detection limits <br /> Consultant Prl.Mgr �j j � �1f�tz U ❑ O possible for 8260 compounds <br /> Cgnaultant Phone#: Fax#: v J ❑❑ ° 3021 MTBE Confirmation <br /> ., m highest hit by 8260 <br /> Sampler:�,yrs�'P F12�cT � - <br /> E "'_ g <br /> � � ❑ ElConfimt all hits by 8260 <br /> Service Order#: ❑Non SAR: Z $ ❑Run—oxy s on highest hit <br /> Date Time [2 o o ° o _ _ F-1Run_oxy s on all hits <br /> Sam le Identification Collected Collected v in O t- m <br /> 3 3 Comments!Remarks <br /> 3 , +� 5 To <br /> , <br /> gtr'DOPE E� , <br /> �' E-T�h4 rJDI. <br /> Reil uished bye: Date Time R y: EPt9 Time <br /> umz.round Time Requested(TAT)(p(easa circle) i _3A 6'90 -• -- y 63 p9?Q <br /> :gin, qT 72 hour 48 hour R oy: a 1Time Receiv by: Date Time <br /> 24 hour 4 day 5 day )3 1�s �u <br /> Relinqui d by: to T e Received Date Time <br /> Data Package Options(please circle if required) <br /> QC Summary Type 1—Full Relinquished b Gal Carrier: R e Date Time <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed UPS FedEx Other <br /> WIP(RWQCB) <br /> Disk Temperature Upon Receipt C° Custody Sea Intact? es 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 />