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rIlia <br /> ` <br /> Lancaster Laboratories For Lancaster Laboratories use only <br /> Acct.#: Sample#: SCR#: <br />. Where quality is a silence. <br /> Analyses Requested <br /> Facility#:_. C Preservation Codes Preservative Codes <br /> Site Address: -� C (f• .. H = HCI T=Thiosulfate <br /> ' -�. ..,. " . .. N = HNO3 B=NaOH . <br /> ChevronPM:_ _� Y^ t ;' r v �- v1_Lead Consultant:_ _ ( C.' _ y ' y S =-H2SO4 0= Other <br /> Consultant/Offioe: r"i` i L ;( i' G �.` � c © c� ❑J value reporting needed <br /> `D ❑Must meet lowest detection limits <br /> Consultant Pd. Mgr.: rw�'i V4, �v C, i='l 5 0 '� <br /> "' possible for 8260 compounds <br /> U <br /> 7C ❑ <br /> Consultant Phone#:t r/IC`�'r(1`� L %UG Fax#:f`i�Ce' �� C.`LU <br /> - • — a� o a N � <br /> N <br /> 8021 MTBE Confirmation <br /> Sampler; r <br /> Confirm highest hit by 8260 <br /> Lu <br /> --_ E m o _ <br /> Service Order#: La ' ❑Confirm all hits by 8260 <br /> ❑Non SAR: a Z i x <br /> Field Repeat Top Time New E 4O x" co o ❑Run`oxy's on highest hit <br /> Point Name Matrix Sam le a th Year Mon#h Da Collected Field Pt. U f° m co ❑Uj <br /> Run_oxy's on all hits <br /> Comments 1 Remarks <br /> Relinquished by: Date Time Received by: Date Time <br /> Tu and Time Requested(TAT)(please circle) —, <br /> ( StD� 72hour 48 hour Relin wish d b <br /> q Y `ITdte Time Received by: <br /> 24 hour 4 day 5 day � ,�Z 1 Z y� Date Time <br /> Data Package Options (please circle if required) Relrnqu shed_ Date Time Received by: Date Time <br /> QC Summary Type l—Full <br /> T e VI Raw Data Relinquished by Commercial Carrier: Received by: Date Time <br /> YP ( ) ❑Coelt Deliverable not needed <br /> WIP(RWQCB) UPS FedEx Other <br /> Disk Temperature Upon Receipt C° Custody Seals Intact? Yes No <br /> Lancaster Laboratories, Inc.,2425 New Holland Pike,PO Box 92425,Lancaster, PA 97605-2425 (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 />