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Chevron California R*ion Ana!jorsis <br /> RequestIchain <br /> +�d5fie�' �h�•-�rFn� For Lancaster Laboratories a only <br /> 1447erequaktyisascknce. G1lV Acct-#: 1 V sample#: i 1 9! to SCR: <br /> Analyses <br /> Requested <br /> Facility Preservation Codes rvatve�Codes <br /> H= H T=Thiosu <br /> lf <br /> ate <br /> Site Address-3 J B=NaOH <br /> S=ItsSOa O=OtherChevron PK-04Vr, Lead Consultant <br /> w f� c ❑ , ❑J value reporting needed <br /> Consultant/Ciffice �T/'�.la,,,e.s_'�` J /G jF.7cr,1r w •- <br /> :4 ry ❑Must meet lowest detection limits <br /> Consultant Prj_Mgr.:_ �� de!F 15?:d !r _ o possible for 8260 compounds <br /> Consultant Phone 9- /L f Ca ax;fE: yid r aye o .a � 0 6021 MTBE Confirmation <br /> Sampler: D v m m w ^ ❑Confirm highest hit by 6260 <br /> H Eg ❑ C3 Confirm all hits by 8260 <br /> Service Order#: ❑Non SAR: $ z <br /> Meld [1 Run oxys on highest hit <br /> -S Repeat TotTime New [1 Run oxys on all hits MontDaColeced Field PointN <br /> . <br /> a}p Q xz PC A I Comments 1 Remarks <br /> Relinq h *,3te <br /> Time Received by: Date Time <br /> rnaro d me Requested(TAT){please arae) <br /> -- STD.-TA - 72 hour 48 hour-` - -T Relinq "shed by:-� Time Received by: Date 'Time T <br /> 24 hour 4 day 5 day <br /> Data Package Options(please circle if required) Relinquished by: Date Time Received by: Date Time <br /> QC Summary Type I-Full <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed Relinquished by Commercial Carrier. o f Received b : D to Time <br /> NP(RWQCB) UPS FedEx Other 1/ ( - <br /> DiskTemperature Upon Receipt C° Custody Seals Intact? es No <br /> Lancaster Laboratories, Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 3460 Rev, 10104/01 <br /> Copts*White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />