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❑ 6110 Chesapeake 11,1,Rh,,d City,CA 94111,(415)3818600 0 18989180Th Ave.,M C,Sure 141.13a WI,WA 98011*(2M)484 9240 <br /> UNOCAL <br /> NAL ! 18 810 Striker Ave..Suite 8•Sacramanta,CA GM4.(916)921-M U fast 11115 Montgomery,Suite S-Spokane,WA 99206•(508)924.9200 <br /> a 1900 Bates Ave,&rite LM,Concord,CA 94520 a(510)BBC-ONO V 15055 8W.Sequoia K,%y.Sute 110•Pont M OR 97222-(61M)624 MIM <br /> Company Name. � IM Prosect Name. Y 7 <br /> Address, ` � UNOCAL Project l►Ilerlltger; 1— <br /> i <br /> aly a Q State. eA Zip Code: 6l Q nelease 0.4�; f -.-) <br /> Telephone {6 - {f FAX ft Site 0- 19 19 7a li, &,-k <br /> r <br /> Re ortToe19 a er. InW100Data 11 Level d tarda U Level C ❑ Level B R Level A <br /> Turnaround 911DWodDays ❑5 Wk DaYs 03 r.kDa s <br /> ❑ Drinking Water Anal sos Re tlestoli <br /> Time. ❑2 workpays C1 1 Work Qpy ❑2-8 Hours ❑ Waste Water <br /> CODE: ❑ mise ❑ Detect ❑ Evai U Rerned L) Demal.U Closure I ❑ other <br /> Client DMITtme Matrix #of Cant Laboratory <br /> Sample I D Sampled Deso. Cont Type Sample 0 Commeerlts <br /> I U — WOW VOA- <br /> 1 , <br /> 3 �` a <br /> 7 " <br /> 4 <br /> 9. <br /> 10. O <br /> is <br /> L <br /> n <br /> Relinquished Sy. Date Time r ReceW ed CQ afs"� s��p Timo- I/-5L� <br /> m <br /> Relinquished By Date., Time, Received By. Date. rare <br /> RelinguJahedEhr I Date; ITIme I Received By LBip, Date. Time, <br /> Were Samples Received in Good Condition?U Yes❑No Samples on Ices Q Yes Q No Mothodaf Shipment _ _ Page—of <br /> To be completed upon racelpt of report <br /> 1) Were the anaWAa requested ort the Chain of Custody reporle& Q Yes a No It no,what analyses are still needed? <br /> 2) Was the tori issued WTthm the requested turnaround time9 0 Yos Cl No if no,what was tho tumaround lime? <br /> Approv .- _-- SigrratTue- Company- D <br />