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* 680 Chesapeake Drive•Redwood City CA 94063•(415 364-9600 C! 18939 120th Ave,N E,Suite 101 -Bothell,WA 98011 •(106)481 9200 <br /> uNo�L (D <br /> J 819 Striker Ave,Suite 8-Sacramento,CA 95$34•(421 9600 U East 11115 Montgomery,Suite B-Spokane WA 99206•(509)0200 <br /> U 404 N Wiget Lane•Walnut Creek,CA 94598-(510)988 9600 Li 15055 S W Sequoia Pkwy Suite 110-Portland OR 97222-(503)624 9800 <br /> Consultant Company eRe-r— a4A- Project Name q3 7C s <br /> Address T 5:,%, a 4d-+R- UNOCAL Project Manager <br /> Cay ) i,,� State Zip Code �( 6 g AFE# <br /> l a <br /> Telephone ZS- SS!- SSS X I q( FAX# '?Z5--'?Z5--5-5-1- 7�$8 Site#, City, Slate 0187 s 4G 1- CA V <br /> Re ort To to ae*t.+ Sam ler P L eC.�rgi'vtel h QC Data % evel D (Standard) rJ Level C ❑ Level B IJ Level A c <br /> Turnaround IJ 10 Work Days Work Days ❑ 3 Work Days IJ Drinking Water lAnalyses Requested I <br /> n. <br /> Time IJ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE. IJ Mise IJ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure IJ Other eb0 �bti �b <br /> Client Date/Time Matrix #of Cont Laboratory <br /> Sample I D Sampled Desc Coni Type Sample# `�� Comments <br /> 1 - -zZ 1 34 [ efi 2 D SI — l <br /> 0 <br /> 2 - 65 _ X <br /> 3 �- ( � 1 [ 4 - vat X x x o.3 <br /> 4 a <br /> 5 <br /> 6 60 x I <br /> 71 -11b — <br /> s I <br /> 9 <br /> 10 1� o <br /> W <br /> 0 <br /> l ca <br /> fielinrluished By Date ! v �I Time ! �U Received 8 ��� -�61e 'I Tlrne <br /> u, <br /> HU111uluisliod By Date time Received By Date Time } <br /> Holuu iu5lied 13V hate Tune Received By Lab Date i niu, <br /> Wei e 5amtdes Heteived in Good Condition?U Yes U No Samples ei i lie� IJ Yes tJ No Method of Shipment Pulte tit <br /> To he completed upon receipt of report <br /> 1) Weie the analyses requested on the Chain of Custody reported? IJ Yes U No If no, what analyses are stili needed? <br /> 2) Ws the iepoit issued will iin the requested turnaround time? IJ Yes+_l No II no, what was the turnaround time? <br /> Apptoved by Signature Company Date <br />