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�. <br /> i ' . �77 <br /> .. _. <br /> Q#hn Analvsis ReqijestlChain <br /> - o I .I . 4 i d l <br /> For Lan r Laboratartes <br /> onl <br /> y <br /> ��.ancaster Laboratories. .. <br /> A I '7 <br /> whera'Quafityisascience m w ��__ - �__ ccL# {J� sample# SCR#: <br /> :. _. ._. .. -=. . Analyses Requested <br /> Facility#: Preservation Codes ervative Codes <br /> Site Address: c . .ii; <br /> =HC TT=Thiosulfate <br /> [ N- 3 B=NaOH <br /> Chevron PM' K Leeaad'Consuttant: <br /> S = H2SO4 0=Other <br /> Consuitant/Office:.T012 .rte E(d sf/GlD .. c �_ 0 ❑J value reporting needed <br /> Y . <br /> IJ Must meet lowest detection limits <br /> Consultant Pd.Mgr:: AEo in possible for 8260 compounds <br /> i c) p <br /> Consultant Phone#' 71-0 LA Fax# i/--rJ7 �_ o K 0 t3021 MTBE Confirmation <br /> Sampter � �-- _ jay �.� m d = ^ 0 Confirm highest hit by 8260 <br /> T © 11 Confirm all hits by 8260 <br /> Service Order#: ❑Non SAR: a z + _ R <br /> Field Repeat Top rime New x ©Run_axy's on highest hit <br /> Point Name Matrix Sample De th Year Month Day CollectedField Pt 0 U to m � � 1 I I p Run,oxy's on all hits <br /> J416-:r, � �� / �'- X Comments Jr Remarks <br /> Sam ;NO <br /> Reli Dat Time Received by: Date Time <br /> =STTD,.'TAT <br /> Time Requested(TAT)(please circle) p <br /> 72 hour 48 hour R 'elinquDate Time Received by: Date Time 4 day 5 day <br /> Data Packs Options lease circle if Relinquished by: Date Time Received b <br /> ge p (p required) Y: ate Time <br /> CC Summary Type I—Full <br /> 'a <br /> Type VI(Raw Data) ❑ Relinquished <br /> Coelt Deliverable not needed rcial Carrier: R by: Date Time <br /> wiP(RWQCS) UPS x Other 4 <br /> Disk Temperature Upon Receipt-1=0C° Custody Seals In es <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 3460 Rev. 10104/01 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink Copy should be retained by the client. <br />