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dy <br /> Vvhmgj S r�r Acct# Sample.*7� Q95-1 Laboratories use o,�ty--sr-R#- <br /> Analyses <br /> lMlee gc�laf�ty s a sconce. <br /> Analyses Requested <br /> Facility#: / � Preservation Codes ve Codes <br /> HCR <br /> Site Address: � Q = B=NaOHfate <br /> Chevron PM,�,k- )9xfc-- Lead Consultant: A S=H2SO4 4=Other <br /> ConsultanV0Mce: l7 el � S� � c ❑ 0 D J value reporting needed <br /> . � - - -- `, Must meet lowest detection limits <br /> Consultant Pd.Mgr.:�{�r a Zg�,s.s o i77 possible for 8260 compounds <br /> 0 ElU <br /> Consultant Phone#:2VVZV Fax#: o cr 8021 MTBE Confirmation <br /> -- <br /> Sampler — l�j� "' $ o c El [IConfirm highest hit by 8260 <br /> Q Confirm all hits by 8260 <br /> Service Order#: p Non SAR: o i <br /> Field Repeat Top Time New � �. ; ❑Run!oxy s on highest hit <br /> PoiName Matri le De th Year Month D ! Fie 0 U h ❑Rum oxy s on all hits <br /> _ I leeX I Comments!Remarks. <br /> 7 <br /> k <br /> lRelinquished <br /> b " a Time Received by: Date Time <br /> d Time Requested(TAT)(please circle) <br /> TD.T 72 hour 48 hour uished by: ate Time Received by: <br /> Date Time <br /> 24 hour 4 day 5 day <br /> Data Package Options(please circle if required) by: a Time . Received by. Date Time <br /> Summary Type i lt Full <br /> Ty Relinquished real Carrier: —rZ %3 Rece by: e a Time <br /> Type VE(Raw Data) QCoelt Deliverable not needed `� 11 <br /> WIP(RWQCB) UPS Other 0. Q <br /> Dlsk Temperature Upon Receipt C° Custody Seals Int Yes <br /> Lancaster Laboraio►ies,Inc.,2425 N8w Holland Pike,PO Box 12425,Lancaster,PA 97605-2425 (717)656-2300 3460 Rev. 10/04/01� <br /> Copies:White and yellow should accompany samples to Lanca,/ aboratories. The pink copy should be retained by the dient <br />