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11 <br /> i -/ rI <br /> f �� U 680 Chesapeake Drive•Redwood City,CA 94063•(650)364-9600 ❑ 18939 120th Ave,N E Suite 101 -Bothell,WA 98011 f(206)481-9200 <br /> a O 819 Striker Ave,Suite 8•Sacramento,CA 95834•(916)921-96001­ I ❑East 11115 Montgomery,Suite B-Spokane,WA 9920(6-(509)924-9200 <br /> ©404 N Wiget Lane•Walnut Creek,CA 945981•(925)988-9600 I ❑15055 S W Sequoia Pkwy Suite 110•Portland,OR 97222•(503)624-9800 <br /> ��❑ee 1455 McDowell Blvd North,Suite D•Petaluma,CA94954•(707)792-1865 <br /> n pany ��I�r�/4 " " Zn G. ZS`ck�YT, Project Nam �rM�r LGis d / .33 d <br /> 16 <br /> SiarrQ ��•- 1 !�� rJ {� UNOCAL Pr ect Manager <br /> State cq_ Zip Code qy�6� AFE # <br /> f <br /> ne S7y/��,�5� FAX6,)Sr1 ; Site#, City, tate yam- <br /> o <br /> Jr2 <br /> ICSampler f1 k,, ��; �� QC Data Level D (standard) ❑ Leve1 C ❑ Level B ❑ Level Aork Days 5 Work Days ❑3 Work Days ❑ Drinking Waier Analyses Requested dork Days ❑ 1 Work Day ❑2-8 Hours QWaste Water <br /> ' d <br /> 11sc ❑Detect ElEval ❑ Remed ElDemol 1❑Closure Other h <br /> Date/Time Matrix # of Cont Laboratory Comments <br /> I m 0 D Sampled Desc Cant Type jf 5ample # <br /> I <br /> v <br /> Z a LSM <br /> _ <br /> —Is <br /> ICU <br /> 6E Oq <br /> r ZZ q k S lil IQ I Y, I Y, I o <br /> f 1 L <br /> I 4 I } O <br /> I L <br /> 0 <br /> I t» <br /> � J <br /> H x IC I + <br /> I <br /> Imqi i sl 4d By Date Time $yj� Received By Date Time f� <br /> i linq 1 d By Date �� ��'I Time / a Received B Date Time <br /> � I <br /> Inq s d By Date Time Date p{ Time <br /> F <br /> e II S eceived in Good Condition? ❑Yes ❑No Samples on Ice' ❑,Yes ❑NoMethod of Shipment Page of_ <br /> I td upon receipt of report <br /> �Vow fte analyses requested on the Chain of Custody reported? ❑Yes ❑ No f no, what analyses are still needed? <br /> W e report issued within the requested turnaround time? O Yes ❑;No If no, what was the turnaround time' <br /> ed Signature Company h '�'� Da IS d <br /> ,�Ii 1 114 111 l i <br />