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• ` .� 0 680 Chesapeake Drive•Redwood City,CA 94063•(650)3640 0 18939 120th Ave,N E Suite 101 •Bothell,WA 98011 •(206)481`92,00 <br /> UNQ A L 0 819 Striker Ave,Suite 8•Sacramento,CA 95834•(916)921-9600 0 East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> 0 404 N.Wiget Lane•Walnut Creek,CA 94598•(925)988-9600 O 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> 01455 McDowell Blvd North,Suile D•Petaluma,CA 94954•(707)792-1865 <br /> Consultant Company. CLO gg!�_ a&" Ik4. 70� a StipciProject Name )C;Mle <br /> Address: � j� 'CLS' UNOCAL Project Manager Mr{ �it� <br /> City State elm— Zip Code qy'j-6 R AFE #. <br /> Site #, City, State: <br /> Telephone* yt�S-�_ �.S-s'r FAX# z,,)ss�-�53� <br /> Sampler: a C Data. Level D (Standard) 0 Level C 0 Level B 0 Leve A , <br /> Report To. p � <br /> c <br /> Turnaround 01d Work Days <br /> 5 Work Days O 3 Work Days 0 Drinking Water Analyses Requested <br /> a- <br /> T€me: O 2 Work Days C 1 Work Day 0 2-8 Hours Waste Water <br /> � <br /> CODE: 0 Misc 0 Detect 0 Eval 0 O Other <br /> Remed 0 Demol 0 Closure <br /> Client Date/Time Matrix # of Cont Laboratory GL Comments <br /> Sample I D Sampled Desc Cont Type Sample # 7 <br /> ,r(A 01 LQl 1 2 Q) 0 <br /> 2:3 Lil <br /> — <br /> 6 S �iD k 4L DIP x <br /> 7 U- (v e, l� L 5 _ D� <br /> 9. <br /> 10 �� ; y 336 10 <br /> Relinquished By. Date Time Pa �� Received By. Date Time <br /> t <br /> Relinquished By Date* Time Received By Date Time <br /> Relinquished By. Date* Time, Received By Lab Date Time. <br /> Were Samples Received In Good Condition? 0 Yes 0 No Samples on Ice? O Yes 0 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? 0 Yes ❑ No If no,what analyses are stili needed'? <br /> 2)Was the report Issued within the requested turnaround time? 0 Yes 0 No If no, what was the turnaround time? <br /> pproved by Signature Company Date: <br />