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r <br /> • o f Ap <br /> • • ! • • • <br /> +Uhcaster"Labor�bries For Lancaster Laboratories use only <br /> Where quality is a science Acct.#: Sample#: SCR#: <br /> _ e J <br /> t Analyses Requested <br /> �. . . <br /> Facility#: Preservation Codes Preservative Codes <br /> Site Address: r: <br /> H W HCl T=Thiosulfate <br /> LeaN =-HNO3 - - B= NaOH-- -- <br /> Chevron PM: -_ �'! }i ui ✓j d Consultant: `JfZ(' c:,f .-, u S=H2SO4 O=Other <br /> �.. <br /> Consultant/Office: _`774-( !_�_ / _'C C. r 6 L i, c © cd> ❑J value reporting needed <br /> ElConsultant Prj. Mgr.: —r V C. 4 1`j' o Must meet lowest detection limits <br /> !;- i;' v <br /> ` C `= 1 r t U ❑ ❑ possible for 8260 compounds <br /> Consultant Phone#: r C. �t• 11(� r t w <br /> i �C 1' Fax#:s (. ��L o N OK — 8021 MTBE Confirmation <br /> Sampler. m o - `' y ❑Confirm highest hit by 8260 <br /> ca <br /> Service Order#: ❑Non SAR: o z , a ElConfin n air hits by 8260 <br /> CL + <br /> Field Repeat Top El Run_oxy's on highest hit <br /> Time New m o o w <br /> PointName Matrix Sam le De th Year Month Da Collected Field Pt -(D F m ❑Run_oxy's.on all hits <br /> �k f- �'r-0 b t Comments 1 Remarks <br /> III LL.� 0 X, <br /> 4Ti <br /> uished by: Date Time Received by: Date Time <br /> T around Time Requested (TAT)(please circle) <br /> TD.T 72 hour 48 hour Re' quis0 d Date Time Received by: <br /> 24 hour 4 day 5 day /�� _ Date Time <br /> RelingtLsh d byik Date Time Received b <br /> Data Package Options(please circle if required) Y= Date Time <br /> QC Summary Type I—Full <br /> Type Vf(Raw Data) ❑Coelt Deliverable not needed Relinquished by Commercial Carrier: Received by: Date Time <br /> WIP(RWQCB) UPS FedEx Other <br /> Disk Temperature Upon Receipt co Custody Seals Intact? 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 Lancaster Laboratories. The pink copy should be retained by the client. <br />