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Pow <br /> LvxagffUo stales <br /> 10 0` <br /> •-. . Forl- nly <br /> ancaster Laboratories use=o <br /> Acet9 <br /> 1/tion tstityisaI Ince - :Sample#: _� �J�Q�J'q�D _ <br /> Analyses Requested - <br /> Facility#: To d G � f fL Preservation codes time codes <br /> Site Address✓? , �j� e <br /> P- NO3 <br /> T=Thiosutfate <br /> ,�j B=NaOH <br /> Chevron PM:, „ -r l / �r S=H2SO4 O=Other <br /> rte— rrLead Consultant: C-B <br /> � U <br /> Consultant/Office'.3. m!7 �0a ❑ cS ❑J value reporting needed <br /> �c•,�. a S <br /> Consultant Pry'.Mgr.: a o m ❑Must meet lowest detection limits <br /> U 1:1 possible for 8260 compounds <br /> Consultant Phone* ��UY� Fax# q,� /C--z o cc,�� 2 o 8021 MTBE Confirmation <br /> epi c� <br /> Sampler: � G d d.•� ' m = w n '� ❑Confirm highest hit by 8260 <br /> ❑ ❑Confirm all hits by 8260 <br /> Service Order#-, ❑Non SAR: z + r "' []Run oxy's on highest hit <br /> Field Repeat Top Time New n «� p ❑Run`oxy's an all hits <br /> P ' M x a e Collected Field Pt. C� U '+a m r <br /> Comments/Remarks <br /> T un Time Requested A Reli is D Time me Received by: Date Time <br /> eq (TAT)(please circle) <br /> as GSl� <br /> STD.T 72 hour 48 hour Relinqu bed by: Time Received by: Date Time <br /> 24 our 4 day 5 day <br /> Date Package Options(please circle if Relinquished Date Time jReceived b <br /> g P ' required) Y: Time <br /> QC Summary Type I—Full <br /> T Relinquished by Commercial Carrier: ed b <br /> Type (Raw Data) ❑GoeR Deliverable not needed i t Y Date Time <br /> WIP(RWQCB) <br /> UPS FedEx Other tl�5 Up,— <br /> Disk Temperature Upon Receipt--- 01- C. Custody Sea tact? Yes No 4 O� <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)6W2300 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 />