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y r <br /> ModraIrnes... For Lancaster-Laboratories°use only <br /> aSC�ew7[e . Acct.M. Sample#: SCR# <br /> M P Analyses Requested <br /> �. Preservation Codes Preservative Codes <br /> I <br /> H-HCI T iosulfate <br /> 331 <br /> 1t Address' t t _ <br /> N=HNO3 B=NaOH-- <br /> t1;PM. UL- Y Gt"J ` C'G�/ y <br /> Lead Consultant: S=H2SO4 0=Other <br /> 2 <br /> ❑J value reportingte <br /> E a° N 2 ❑Must meet lowestttionNm• <br /> o r 0 possible for 8260 mpoun <br /> F U <br /> z <br /> t2't Phone#:016 l/l/- C(/r p 2 Fax#: [ �1I��l u/ Irl o g . 8021 MTBE Confirm <br /> , ': ►r j3r.,,�r,�, rj.�1 rl.r_y a .� d 0 Confirm highest hit YA260 <br /> ' y � m a, ❑Confirm ail hits by .28� <br /> er#Y <br /> [I Non SAR: _ z $ p Run_oxy's on higtueSk}llk_" <br /> Repeat. Top Time New TE «� <br /> p Run_oxy's on all hits <br /> m =�` Matrix -Samole th- De Year Month Dav Collected Field Pt. (D 1 U '>° m <br /> may: _ <br /> F0 U X Comments 1 Remarks <br /> F <br /> Mon <br /> I W1 <br /> t� <br /> } j <br /> - f <br /> , <br /> t: <br /> - ... <br /> Relinquished by' Date Time Received by: Date Time <br /> and Time Requested(TAT)(please circle) <br /> rS� ATS 72 haur 48 hour Relinquished by: ry Date Time Received by: Date Time <br /> 4 day. 5 day <br /> z <br /> $'raCka e fl tlotlS; lease cirGe if required)'. r �n d by' at Time Received by: Date Time <br /> �s p cp � �. 1'3 � <br /> TYpe I='Full <br /> Relinquished y ommercial Carrier: Received by:.. Date Time <br /> C]Coeft Deliverable not needed <br /> UPS dEx � Other ' <br /> f y Temperature Upon Receipt Co Custody Seals Intact? Yes No... <br /> 3460 Rev. 10/04/01 <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO'Box 12425,Lancaster, PA 17605-2425 (717)656-2300 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client i; <br />