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❑ 680 Chesapeake Drive•Redwood City,CA 94(415)364-9600 ❑ 18939120th Ave,N E,Suite 101•Bothell,WA 98011•(206)461-aLW <br /> 0 819 Striker Ave,Suite 8•Sacramento,CA •(916)921-9600 O East 11115 Montgomery,Suite B•Spokane,WA 99206• 249200 <br /> UNtCAL , O 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686-9600 o 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•( )624 9800 <br /> Company Name G 7 T W—C. <br /> Project Name NOCA Svc. r. <br /> Address O G• "M JV PRI 17V NOCAL Project Manager NiCV, NICWF9--fi-0 <br /> City A Al�0 (,OR�' tate Zip Code Q Release# c <br /> 6� 31.1317 51te# D �o�. v Oo 3 <br /> Tele hone L 3 3 O//0 FAX# , <br /> Report To �V Sam ler C}C[ia aj Level D (standard) ❑ Levef C ❑ Level B ❑ Level A <br /> Turnaround 0 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water Anal ses Re nested <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Flours ❑ Waste Water <br /> CODE: ❑ Misc ❑ Detect XEval ❑ Remed ❑ Demol ❑ Closure ❑ Other �`� <br /> Client Date/Time Matrix #of Cont Laboratory44. Comments <br /> Sample I D Sampled Desc Cant Type Sample# � <br /> 0 <br /> u-2(o 4-F z °z �� 5 o <br /> 3 (�( -2(. 16.5 o <br /> o <br /> 4 (A —2(a— 21.5 /00 <br /> 5 Ul—1(,p — 2�- 5 101-L --Q <br /> 6 U--Z4 - 31.5 /0i8 1 / <br /> 7 (A-2(p - 35.5 ioz 1 <br /> 9 3 0 <br /> 10 LA —2-(p — //01 E _t <br /> 0Z- ime <br /> (n� ll FW tv <br /> Date 0 Z T 1300 Received B Date,,2- P Z Time 7i <br /> Relinquished By w <br /> cc�� LReceived B imeRelinquished 8y Date �L Time %OS <br /> Relinquished B Date Time Received By Lab Date Time <br /> Were Samples Received in Good Condition?❑Yes 0 No Samples on Ice9 ❑Yes O No Method of Shipment Page_of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? a Yes❑No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes❑No If no,what was the turnaround time? <br /> Approved by Signature Company Date <br />