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f r r RWon / rq RpquestlChain. of C6&dy <br /> Lancaster Laboratories For Lancaster aboratories use only D ] <br /> Acct.# r oma Sample# 1 �} SCR#: <br /> tMaerequalityrs a scilence <br /> Analyses Requested <br /> Facility#: g� T� 77a���S /'ri/L Preservation Codes tive Codes <br /> Site.Address:3 �,r �+ _HCR T=Thiosulfate <br /> a B=NaOH <br /> Chevron PM: = <br /> _ram.n_ L7sfS�, lead Consultant: S H2SO4 O=Other��C�/Q <br /> Consultant/Offioe�GY 7 ���a./t�+_ ��Q�j IFI"sha ). El F_1 J value reporting needed <br /> ❑Must meet lowest detection limits <br /> Consultant P1.Mgr.: possible for 8250 compounds <br /> d 0 <br /> Consultant Phone#: 7��_ �raf*Xw Fax#: Q� d. —Q a o 8021 MTIBE Confirmation <br /> i. N 0. N <br /> Sampler.' a wa ❑Confirm highest hit by 8260 <br /> Service Order M ❑Non SAR: Z ❑Confirm all hits by 8280 <br /> + S Q [3 Run_oxy's on highest hit <br /> Field Repeat Top Time New m E r 4 <br /> Poin Name trix m le De Year Mon a Goll P. C7 v m k C4 ❑Run_ oxy's on all hits <br /> D 4 Comments!Remarks <br /> { Oji <br /> Relinquished by Date 7' a Received by: Date Time <br /> nd Time Requested(TAT)(please circle) /F-0' d s' <br /> TAT 72-hour--- 48,hour T T - Relinqui - —ate _Tgne'-Receiv by� -Date - Time <br /> 4 day 5 day --� <br /> Data Package Options(please circle if required} Relinquish Date Time Received by: pate Time <br /> QC Summary Type I-Full <br /> Type Vf(Raw Data) ElCoelt Deliverable not needed Relinquished by Commercial Carrier: Received by: l{'�] t Time <br /> WIP(RWQCt3) UPS FedEx Other <br /> Disk Temperature Upon Receipt Co Custody Seals Intact? Ye No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17505-2425 (717)656 2300 3460 Rev. 10104101 <br /> Copies:White and yellow should accompany samples to-Lancaster Laboratories. The pink copy should be retained by the client. <br />