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Chevron Califomial Region Analysis RequestlChain of Custold <br /> �Lancaster a}�orfOr� For Lancaster Laboratories use only <br /> Wherequalityisasaence. [1l ,Acct.#: Sample#: SCR#: <br /> Analyses Requested <br /> Facility#: ` % Ll 5 Preservation Codes Preservative Codes <br /> n ' `~ i i `'_. H= HCI. eT=.Thiosulfate <br /> Site Address: = f c. ,, r"? 3 N = HNO3 B= NaOH <br /> �" S=H2SO4 O=Other <br /> Chevron PM: r +-` ;'( �!Y !_ Lead Consultant: :. �'l AD <br /> ( +:. , ! ❑ } z ElJ value reporting needed <br /> Consultant/Office: C ! v C T <br /> ;g �, J �; ❑Must meet lowest detection limits <br /> Consultant Prj. Mgr.: vpossible for 8260 compounds <br /> - L{d G U ❑ ❑ <br /> Consultant Phone#: !��l y C��( "{� /�"(. Fax#a` i{c.={ � r'' <<..J�} o o p ❑ 8021 MTBE Confirmation <br /> l i I i ' 4 fC �; .... ' .� f11 U V3 v ' <br /> - � <br /> Sampler f ' ' r'1 C. CD Q Confirm highest hit by 8260 <br /> Service Order* � � x ❑ ❑Confirm all hits by 8260 <br /> ❑Non SAR: o y s- o <br /> CL + o o ❑Run—oxy's on highest hit <br /> Field co <br /> Repeat Top Time New o o _ ❑Run oxy's on all hits <br /> Point Name Matrix Sam le De th Year Month Da Collected Field Pt. F- mCL <br /> Comments 1 Remarks <br /> Relinquished by: Date' Time Received by: Date Time <br /> Turn d Time Requested (TAT)(please circle) - <br /> S 72 hour 48 hour Relinquished : Date Time Received by: Date Time <br /> 24 hour 4 day 5 day p <br /> 1 lu"G Ct t IZLI <br /> ,E f ' <br /> Data Package Options(please circle if required) » - R lin�ui ed Date Time ,Received by: r Date Time <br /> QC Summary v _ ,Type I-Full n v <br /> Type A(Raw Data) ❑Coelt Deliverable not needed Relinquished by Commercial Carrier: Received by: x Date Time <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,Pr <12425, Lancaster,PA 17505-2425 (717)656-2300 Q Rev. 10/04/01 <br /> Copies:White and yellow should accompany samples to Lanck Laboratories. The pink copy should be retained by the client. C` <br />