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Chevron Ca' lifomia Region Analysis Req!iestl0h.-lin of Custody <br /> LamAer L&orato les For Lancaster Laboratories use only <br /> �Q� ' Sample#k- L y <br /> Wherec�.,aRyisasdcnce, <br /> ext.e L-}5 t t3t� --I O. sCR#: <br /> - k Analyses Requested i <br /> Facility* Preservation Codes ative Codes <br /> f Y HCi T=Thiosulfate <br /> Site Addre55r• '1 1^� r, "� /�,' N- 3 8=NaOH <br /> Chevron PM: .;, Z�ead Co—ns'ulttannt: 3=H2SO4 O=Other <br /> 12 <br /> Consultant/Office: ❑. ©J.value reporting Headed <br /> c 0 Must meet lowest detection limits ' <br /> Consultant Pr#_Mgr.: o cn possible for 8260 compounds <br /> Consultant Phone#: Fax#, � ..,�..�ti b o © C o ❑ 8021 LI BE Confirmation <br /> Sampler: "' °� co o.. � � ❑Confiim highest hit by 8250 <br /> Uj <br /> Service Order#: w � °Q g ❑ 0 Confirm all hits by 8260 s <br /> p Non SAR: z o o ❑Run^axy's on highest hit <br /> Repeat Top Tyne New E ._ro W m z - �9 <br /> E x .� ❑Run oxy s on all hits <br /> trix a De h Year Mo h ba Collected Field. C7 v �- m r m <br /> LeifeComments 1 Remarks <br /> INIZ <br /> n. <br /> s ' <br /> t r <br /> d Tlme Requested(TAT)(please circle) y w lnquished D e Time Received by: Date Time' <br /> 5TD.TAT -72 hour 48 hour ft •n <br /> 24 hour4 day 5 day Date Time Received by: Date Time <br /> Data Package Options(please Circle if required) nq Y: Date Trcne Received by: - Date Time <br /> QC Summa � . <br /> H;, 4 ..TYpe I=Fuil <br /> .Type Vi(Raw Data) ❑Coelt Deliverable not needed Relinquished erclal Carrier, by.- <br /> T <br /> WIP(RWQCB) LIPS Fed Ex Other Y l <br /> Disk Temperatur n Receipt-%L4-C° k Custody Seals act? Yes No <br /> Lancaster Laboratories,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 Lance ' '"aboratories. The pink copy should be retained by the client. <br /> �r <br /> �j - <br />