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For Lancaster Laboratories use only <br /> ' <br /> #: Sample M. - - SCR#: <br /> Analyses Requested <br /> - <br /> F_. e <br /> Preservation Codes _ Preservative Codes.. <br /> H'= HCI T Thiosulfate . <br /> n3ss "LGA a N= HNO3 B=NaOH <br /> Lead Consultant: S= H2SO4 O=Other <br /> *, L <br /> - — ❑J value reporting needed <br /> ntlOffioe. F'C�� ` 4. m . - - <br /> r ro N ❑Must meet lowest detection limits <br /> tarnP . M r.: J G�;V r C CLQCr b�l S = o , <br /> rJ o ❑ ❑ possible for 8260 compounds <br /> C <br /> nt Phone L� 'KZ � ation o <br /> ❑ <br /> 8021 MTBE Confirm <br /> N W N <br /> hd o Confirm highest h" 1 60 <br /> = <br /> n m T © ❑Confirm all hits by k60- <br /> &A ❑Non 5AR: QLn <br /> + ❑Run_.oxy's an higtiest hit <br /> Repeat Top Time New e c F N ❑Run_oxy's on all h w: <br /> a nt�Name Matrix am le De th Year Month Day' Collected Field Pt. v F- m rcc -1 <br /> Comments/Remarksz <br /> 1 <br /> Relinquished by: Date Time Received by: _.. _. ._ -Date Time <br /> rqund Time Requested(TAT)(please circle) <br /> A7 72 hour 48 hour Relinquished by: Date Time Received by: Date. Time <br /> J vur` 4 day 5 day <br /> eli qw by- �?� - Time Received by: Date Time <br /> kag9 Qptror#s(please circle if.required) 30 <br /> wriinary r,` Type I.-Full <br /> Relinquished b ommercial Carrier: Received by: Date Time <br /> VI(Raw Data) C]Coelt Deliverable not needed DPS Fe Ex other <br /> AK Temperature Upon Receipt Co Custody Seals Intact? Yes No LL' <br /> x' ;460 Rev. 10/04101. <br /> Lancaster Laboratories, Inc.,2425 New Holland Pike PO ox'12425,Lancaster, PA 17605-2425 (717)656-2300 <br /> X Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />