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F !_ �� �I�'_ ��: Y Lo- �, •��� ■ ■ <br /> Chtivr1 + <br /> A WN <br /> 1F' <br /> • .;.- ' r <br /> n rLa rias use only <br /> 3ampte#: `?✓3— sefde: X333 .. <br />- - •VVhere� isaxcreitc _ T w.,_. �. _� - - — -- <br /> Analyses Requested <br /> Facility Pieservatloo Codes rvative Codes <br /> HCI T=Thiosutfate <br /> Site Address; q <br /> 3 /C .� .� B=NaOH <br /> Chevron PM:-Ar-,6^ Rl v-0Lead ConsuRard, S= H2SO4 O=Other <br /> LO <br /> Consu[tant/Otfioe: G/ gad <br /> 0 J value reporting needed <br /> ° r ❑Must meet Lowest depecGon limits <br /> Consultant Pd.Mgr.:�IJG.i�� o m possible for 8260 compounds <br /> Q <br /> Consultant Phone#: Fax#: 2�5��� n � a � 8021 MTBE Confirmation <br /> Sampler / m w Q a 0 Conftrm highest hit by 8260 <br /> Service Order#: Q on SAR: Z �' ❑CoreTrrm all hits by 8260 <br /> n $ + g ❑Run_oxyrs on highest hit <br /> Field Repeat Tap' Time New m E 0 x = <br /> Point N Sample' ear M a Coll Feld P 0 t.- m Q Run i ozy's an all hits <br /> zAP Comments!Remarks <br /> J i 7"S,a <br /> 01 <br /> Relinquito me Received by: Date Time <br /> i <br /> Trme Requested(TAT)(please circle) Q� �,�- <br /> STD.T 72 hour 48 hour R quos by: _ .Tune Received by: Date Time <br /> our 4 day 5 dayV21 'A <br /> r� <br /> Data Package Options(please circle if required) a Time Received by: Time <br /> QC Summary Type I-Full <br /> cashed <br /> Type VI(Raw Data) Q Coeft Deliverable not needed Relin q mmercial Carrier- <br /> Rene' bY�_ Date Time <br /> %MP(RWQCB) UPS (Le d.E Other r U of <br /> Disk Temperature Upon Receipt 1^_j C. Custody Seals Intact? Yes o <br /> LancasterLaboratorles,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 3460 Rev_10/04/01 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />