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r <br /> Label'LaWftrie5 ,4CCL#. V For 0al= <br /> ;}� ries use only r-f <br /> wtt�c ayisasdencta 0Sample#:� ries use <br /> _SCR#: 9or13 <br /> Analyses Requested t <br /> Facility#: �' (� 11/► Preservation Codes <br /> L Presentative Codes <br /> n =HC - <br /> Site Address: T=Thiosulfate <br /> s C H=HNO3 8=NaOH <br /> Chevron PM:Alf+V1 Lead Consultant: E2 � S=1-12SO4 O=Other <br /> ConsultantlOffice.� 7- CA k)a <br /> I-1 , N ?r4 E2 <br /> c� ❑J value reporting needed <br /> AG <br /> Prj:Mgr.: o o ❑Must meet lowest detection limits <br /> Possible for 8250 compounds <br /> Consultant Phone#C1 f� f�� ca ❑ <br /> 1J1_�� d`��U Fax#: I -- C� --C -i# o (Cr) o ❑ p <br /> 8021 MTBE Confirmation <br /> 0 2i 14 <br /> l Sampler: ��,.._.Af1 —,-,—,-,---•.- m w ❑Confirm highest hit by 8250 <br /> Service Order#: W � m ❑ ❑Confirm all hits by a260 <br /> s ©Non SAR: z 4* <br /> + ElRun oxy's on highest hit . <br /> Field Repeat Top Time New O & = a <br /> n Name Matrix Sa t De Year Mo Field Pt. C7 U m ❑Run oxy s on all <br /> hits <br /> 4r Commeirits I Remarks <br /> Y r A <br /> �.1CA PiLa.SEiZOdfl z . <br /> } <br /> Relinquished Date Time Received by: Date Time <br /> Time Requested(FAT)(please circle) �-` Dfl a _. <br /> C2o <br /> TAT 72 hour 48 hour- etin uished f Date TrEne Received by_ Date Time <br /> ur 4 day i 5 day �` ry <br /> Data Package Options(please circle if required) a Date Time Received by D Time <br /> OC Summary _Type I-Full <br /> Type VI(Raw Data) pCoelt Deliverable not needed Relinquis CVrftmerciall Carrier. Received t? : <br /> Y. Date Time <br /> WIP(RWOCS). UPS led Otheri 12.. S(j <br /> DiSk Temperature Uport Receipt C° Custody Seals fntA Yes No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17505-2425 (717)656-2300 3460 Rev. 10/04/01 <br /> �, Copies:White and yellow should accompany samples to Lance' <aborataries. The pink copy should be retained by the client. <br />