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Z o 2 <br /> • + 0 880 Chesapeake Drive•Redwood Ci CA 940tH• i <br /> UNOCAL � � {650)364-9600 Q 18939 120th Ave.N E Suite 101 •Bothell,WA 98011 •(208)481.9200 <br /> ❑819 Striker Ave,Suite 8 a Sacramento,CA 95834•(916)921-9600 0 East 11115 Montgomery,Suite B•Spokane,WA 99206-(509)924-9200 <br /> 0 404 N Wiget Lane o Walnut Creek,CA 94598•x(925)888-WW O 15055 S W Sequoia Pkwy,Suite 110 Portland,OR 97222•(503)624-9800 <br /> O 1455 McDowell Blvd North,Suite D•Petaluma,'CA 94954•(707)792-1865 ` <br /> F <br /> Consultant Company �, 4" PA c., J74 00��j'I" Project Name: <br /> - <br /> Address: 6 UNOCAL Project Manager. <br /> City. - State: , g Zip Coda. �� 9' iAFE - <br /> Telephone L.. ;Z I-rFAX # Za, li —, Sfte #, City, State,Y <br /> Report To: n - iSampler. i �� 'Qd Data evel D (Standard) Q Level C O Level B Q Level A U _ <br /> ZY <br /> Turnaround ❑ id Work Days 5 Work Days 0 3 Work Days - 0 Drinking Water Analyses Requested = <br /> Time: 0 2 Work Days ❑n1Wtsrk Day 0 2-8 Hours - < a <br /> F ,! Waste Water a _ <br /> CODE: ❑ Mlsc 0 Detect, ❑ Evai , 0 Remed ❑Demol O'IClosure 0 Other <br /> Client DateMme Matrix # of si Cont Laboratory + Comments <br /> Sample I D Sampled Desc Cont Sample # _ <br /> 2. <br /> 5. Z�66 At 17 3� Y\ - - } <br /> 6. <br /> 4 10 <br /> 7 <br /> 9 <br /> 10 <br /> Relinquished By Date, 'y ! Time:--(~� ' eceived By. �� - Date-/XZ;'v Tlme; <br /> Relinquished By Date �� Time - Received By Date Time 3 <br /> Relinquished By _ Date-�- P Time: _ Received By Lab Date <br /> Were Samples Received In Good Condition? ❑Yes Q No - ' - !Samples on Ice? ,L)Yes t7 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? O Yes 0 No If'`no,�what analyses are still needed? <br /> 2) a report issued within the requested turnaround time?1, Q Yes ❑ No If no, what was the turnaround time? <br /> Approve*..... SI nature I� <br /> g __ Company <br />