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❑i 680 Chesapeake Drive•Redwood City,CA 94063•(415)384-9600 ❑ 18939120th Ave,N E,Sulle 101 •Bothell,WA 98011 •(206)481-9200 <br /> UNOCAL <br /> s O 819 striker Ave,Suite 8.8e crarne to,CA 95834:(916)921-9600 13m 9206 East 11115 Montgomery,Suite B•Spokane,WA 9 •(509)924-9200 <br /> ❑ 404N Wiget Lane•Walnut Creek,CA 94598-(51,0)988-9600 ❑ 15065 S W Ssquok Pkwy,Suite 110•Portland,OR 97222•(503)624.9600 <br /> Consultant Company <br /> Project Name <br /> ��,�- � �ne.. ��}�. Z-S2�,d Sid' <br /> Address:6�� - .S%urY� rf 5�.�.r�� �i UNOCAL Protect Manager. M • �* <br /> City, u b lr I - <br /> State: *� zip Code Q��f j"'6� AFE# � c <br /> k 9 <br /> Tele hone: S` FAX E Site#,City, State S EA <br /> v <br /> Re ort To n am ler U '� QC Data Level ❑ standard ❑ Level'C ❑ Level B _ _ L) LevelC <br /> o_ <br /> Turnaround ❑ 10 Work Days AS ork Days ❑ 3 Work Days ❑ Dnnking Water Anai ses Re uested <br /> Time: ❑ 2 Work Das /❑ 1 Work Day ❑ 2-8 Hours Waste Water O <br /> CODE: ❑ Misc ❑ Detect ❑ Eva] ❑ Remed ❑ Demol Cloit sure ❑ Other 9 <br /> Client D_ ate/Time Matrix #of 1Cont Laboratory O <br /> Sample 1.1) Sampled Desc Cont i, <br /> Type Sample# Comments <br /> c� � 'i l� o� - -�01 191 _ ou - <br /> 4. Z Z K k <br /> fir► J` m <br /> 5. 3 — d#_ <br /> D <br /> 7 ra- Lra& <br /> I, FK <br /> 10 1 <br /> Relinquished By Date Recdliiid :` —� Data Time , <br /> Relinquished By Date # Time Received B : Date Time <br /> Is B Date + Time. Received Lab Date Time <br /> Were Samples Received in Good Condition?❑Yes❑No r Samples on Ice?-❑Yes❑ No Method of Shipment_ Page , of_ <br /> H <br /> To be compleM upon receipt of report, _ <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes 0 No If no;what analyses are still needed? <br /> 2) IN <br /> he report Issued within the requested turnaround time? ❑Yes❑No If no,what was the turnaround time? <br /> prove Signature ii Company <br />