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_ '}� t • • <br /> �.aJQ�Qri� For Lancaster Laboratories use only <br /> +Lancaster Where quality is a soence. A� # Sample#: <br /> SCR#: <br /> - <br /> _ <br /> Analyses Requested <br /> Facility#: S Preservation Codes Preservative Codes <br /> Site Address: ECA Y Y 1x 1 -Y) H =HCl T=Thiosulfate <br /> _a . . <br /> N-HNO3 B= NaOH <br /> Chevron PM: ✓ Lead Consultant:'Q[' y� y S=HZSO4 O= Other <br /> Consultant/Office: c� ❑J value reporting needed <br /> co <br /> R <br /> Consultant Prj, Mgr.: 1 IJ. [) V G1 ci1 o m 65 ❑Must meet lowest detection limits. <br /> U ❑ Q ❑ possible for 8260 compounds <br /> Consultant Phone#: (�f�� �-- ocf Fax#: /9/0 Ryl-D o o 0 O ❑ <br /> 1 f - C4 C7 cr �, 8021 MTBE Confirmation <br /> CD CO <br /> Sampler: t�V,4 `�v)Q� ��lJy) m o o c ❑Confirm highest hit by 8260 <br /> Service Order#: ❑Non SAR: 2 ❑ <br /> a Z � ., y N ❑Confirm all hits by 8260 <br /> Field Repeat Top Time New E f x m o ❑Run oxy,s on highest hit <br /> O p w x z <br /> Dint Name Matrix Sam le De th Year Month Da Collected Field Pt. C7 U E- m J9 Run oxy's on all hits <br /> 1 � �Vo <br /> 1 UComments 1 Remarks <br /> +� D ! <br /> Turnaround Time Requested (TAT)(please circle) Re d by' pate. Time Received/1 by: Date Time <br /> 13 <br /> TD. 72 hour 48 hour elinqu <br /> 24 hour 4 day 5 day ate Time Received by: Date Time <br /> JO-)-J- ?J-'L� <br /> Data Package Options (please circle if required) elin ui edr y: Date Ti Received by: <br /> Date Time <br /> QC Summary Type I—Full <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed Relinquished by Commercial Carrier: Received by: <br /> WIP(RWQCB) UPS FedEx Other Date Time <br /> Disk Temperature Upon Receipt C^ <br /> 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- 10l04lo1 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />