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Chevron Ca I Iffibmia'Region Analysis RequestlChain of Custody <br /> For <br /> Lancaster bbo `""des Acct.# ! � Sample#:La star o torlea use only SCR#: <br /> Where quaRyis a screrlce <br /> Analyses Requested <br /> Facility#: Preservation Codes ervatJve Codes <br /> =HCI T=Thiosulfate <br /> Site Address: 33'� I,J :. X71` .dd C.__.et_--- g - 3 B=NaOH <br /> Chevron PM: L� G Lead Consultant: Cd _ S=HzSOa O= Other <br /> Consultant/Otriice: b17 �!� c ❑ c� ❑ value reporting needed <br /> ,tom ❑Must meet lowest detection limits <br /> Consultant Pd,Mgr.: R✓O✓G <br /> possible for 8260 Compounds <br /> Consultant Phone#: /6— /~O�IL2"� Fax#: 9/�-� `�L Q ❑ 8021 MTBE Confirmation <br /> C]Confirm highest hit by 8260 <br /> Sampler: iG r X7" a -- ❑ <br /> 7 o, ❑Confirm all hits by 8260 <br /> Service Order#: _O NonSAR: a Z "' <br /> Field Repeat _Tog Time New E �+55 n ❑Run____oxy's on highest hit <br /> Point MatrixSam le Depth Year Month Da Collected Field 0 � H m � � � � ❑Run_oxy s on all hits <br /> Comments t Remarks <br /> elinquis by: ate Time by: Date Time <br /> d Time Requested(TAT)(please circle) I lig <br /> STD.T 72 hour 48 hour R quls y: Q to Time Received by: Date Trme <br /> our 4 day 5 day ,� ( <br /> Date' Time Received by: sme <br /> Data Package Options(please circle if required) inqui Date <br /> QC Summary Type I—Full <br /> Type%!(Raw Data)' C]Coelt Deliverable not needed Relinquished by Commercial Carrier: Re d y; bate Time <br /> WP(RWQCB) <br /> UPS FedEx Other �N G' } <br /> Disk Temperature Upon Receipt C° C Seal Intact? Yes <br /> Lancaster Laboratories,Inc,,2425 New Holland Pike,PC}Box 12425,Lances�r,PA 17605-2425 (717)656-2300. <br /> 3460 Rev. 10/04/01 <br /> 'Copies:While ericl yellow sh6uld accompany samples to Lancaite,-' #baiatories. T46.pink copy should be retained by the client. `"� <br />