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{'' U 680 Chesapeake Drive•Redwood City,CA 94063 01'(650)364-960D U 18939 120th Ave,N E butte tUt •tioineu VVA V?JU I I •iclIJoj 401-zlcvu <br /> ' ❑819 Striker Ave,Suite 8•Sacramento,'CA 95834•(916)921-9600 ❑East 11115 Montgomery, Suite a•Spokane,WA 9920 •(509)924-9200 <br /> ❑404 N Wlget Lane•Walnut Creek,CA 94598•(925)988-9600 0 15055 S W Sequoia Pkwy Suite 110•Portland,OR 97222-(503)624-9800 <br /> 0 1455 McDowell Blvd North,Suite D•Petaluma,CA 94954•(707)792-1965 ! <br /> 1 <br /> n pany , .,4 1, ,C . jr,-)9.0 2, bO44r Protect Nam �o Gd I SS p/ <br /> '�-���r►^q , �� 7 UNOCAL Prefect Manager <br /> State Zip Coder �` AFE# [�� <br /> sL'4 g S <br /> � 4 i <br /> n <br /> ' n411r­ <br /> [Analyses <br /> (_ S r� FAX 4zsss7C Slte #, City, tateCAM <br /> Sampler fi, IS OC Data Levet D (Standard) © Level C ❑ Level B ❑ Level AY Re nestedIr, u0 Work Days ❑5 Work Days ❑3 Work Days'; ❑Drinking Waterq a- <br /> i, 2 Work Days D 1 Work Day ❑2-8 Hours jWaste�Water ! id. b� <br /> Isc ❑ Detect ❑ Eval ❑Remed ❑Demol 0 ClosureiI D Other y� <br /> Date/Time Matrix #of Cont l laboratory otComments <br /> r aM i D Sampled Desc Cont Type 'r Sample # <br /> i 00 <br /> 0 <br /> ^0 <br /> f I i •� I � r y <br /> E' ► Z h ti- <br /> 11 <br /> 0 <br /> 13° r S l E <br /> 37 <br /> 157 <br /> UN1 ! <br /> I <br /> I y <br /> ingrs i 1e;'d By Date �' Time � h Received By Date ,t '� Time 4im <br /> L <br /> >" ingi�sd By G^ �� Date ,��1- 1 <br /> Time Received; Received By Date Time <br /> � <br /> ' <br /> l �ti i �+l � <br /> pl fngl d By Date Time. R Date T Time <br /> imp;` eceived in Good Condition? ❑Yes ❑No Samples on Ice? 0 Yes ❑No, Method of Shipment ; Page—of_ <br /> f # ed upon receipt of report <br /> ,I <br /> VV he analyses requested on the Chain of Custody reported? ❑Yes, 0 No If no, what analyses are still needed? <br /> e report issued within thhe, requested turnaround time, Yes No If no, what was the turnaround time? <br /> Slgnatu e e ompany-� - D <br />