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Chevron Califo,nia Region Analysis Request/Chain of Custody <br /> �}�,�},, n For Lancaster Laboratories use only 1-7�O <br /> +Lamaster L abo aWre Acct.# V _ Sample*q:5 K 5` X10-1 --"Ae <br /> 1Maere cualirya a science <br /> q Analyses Requested <br /> Facility Preservation Codes Preservative Codes <br /> . � �O� �� Fl=HCI T=Thiosuifate <br /> Site Address: ytea '' <br /> 33 <br /> ., 2 _ N=HNO3 $=NaOH <br /> Chevron PM:.&L? e rDt;h Lead Consultant: U_ 3=H2SO4 D=Other <br /> �1 <br /> G+Gr^� G © ©J value reporting needed <br /> Consultant/Office: es ❑Must meet lowest detection Omits <br /> y possible for 8260 compounds <br /> Consultant P1. Mgt.: Dx v <br /> Consultant Phone#-(CPc GfJ Fax# ��� ! D o 2 00 © 8021 NfBE Confinnation <br /> Q LQ—. pyK [J✓7 ro m a o ~ ❑Confirm highest hit by 8260 <br /> Sampler. -- E `off © 0 Confirm all hits by 8260 <br /> Service Order#: Non SAR: 'a .z $ $ i ti ❑Run_oxy's on highest hit <br /> Feld Repeal Top Time New o a ' ©Run-___oxy's on all hits <br /> ame M Samp1p, e Year MordhL9 U F- m <br /> Oy ID / l u O (0 1 Comments l Remarks <br /> I LO SO <br /> Poi <br /> Re[i h Date Time Received by: Date- Time <br /> T and Time Requested(TAT)(please circle) <br /> STD.T 72 hour 48 hour linquis ed Date Time Received by: Date Time <br /> 24 hour .4 day• 5 day <br /> Relinquished by: Date Time Received by: Time <br /> Data Package Options(please circle if required) <br /> QC Summary Type I-Full Relinquish ercial Carrier: a ived by. <br /> Type V1(Raw Data) QCoell Deliverable not needed Time <br /> _ <br /> VIP(Rv4 ccs) UPS FedFac Other <br /> Disk Temperature Upon Receipt3460 C° Custody Seals et? es <br /> Lancaster Laboratories,Inc,2425 hlewt.olland F%p,FO BrwL124Z5,i ancaslrrt PPS 9�fRev. 1010d/fl1 <br /> _ --- -- - - <br /> - Copies:White and yellow should accompany samples to Lance rrataries. The pink copy should be retained by the client. <br /> _ - - <br />