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,-1 U30 Chesapeake Drive-Redwood City CA 94 •(.415)364 9600 U 18939 120111 Ave,N E,Suite 101-Bothell,WA 98011 •(206)481-9200 <br /> UCAL (D <br /> U 819 Striker Ave Suite 6•Sacramento,CA 95(916)921 9600 U East 11115 Montgomery,Suite B•Spokane,WA 9921)6 0)9249200 <br /> U 404 N Wigel Lane•Walnut Creek,CA 94598•(510)988 9600 U 15055 S W Sequoia Pkwy,Suite 110•Portland.OR 97222•(503)624 9800 i <br /> Consultant Company Project Name ��yyu a y 7!� �1��r <br /> P Y n e✓ L1'tl 77G f. <br /> '� r �"�� T UNOCAL Project Manager0- <br /> [Address-67Y/ <br /> ,� ��7` <br /> Address I ✓ r`✓� C �tl� J <br /> City G1 y/m State Cr, Zip Code 9E6t AFE # F <br /> Telephone q�S ��� FAX# �v � Site #, City, State 0/6 I S rv1 CYJ U <br /> Re rtTo 61 n*. C!'1 CWSam ler �1C, /�C. 0C Data vel D (Standard) ❑ Level C ❑ Leve! B Cl Level A c <br /> a <br /> Turnaround "Work Days ❑ 5 Work Days 1:13 Work Days ❑ Drinking Water lAnalyses Re uested <br /> Time ❑ 2 Work Das ❑ 1 Work pay ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc U Detect ❑ Eval Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Dale/Time Matrix # of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> z <br /> 2 <br /> 0 <br /> Cz <br /> 3 <br /> U� � <br /> �- ��1 3 <br /> 4 <br /> 5 <br /> 6 _z _ zz <br /> P-2- 11 <br /> $ P-z & i <br /> 9 <br /> 0 <br /> 10 <br /> C <br /> Relinquished By Date '4 Time Received B Date Time S <br /> a <br /> Relinquished By Date '� Time ] 1010 Received B Date Time <br /> 012121q9 <br /> Relinquished By Date I Received By Lab G Date Ttme <br /> Were Samples Received in Good Condition?U Yes U No Samples on Ice? U Yes❑ No Method of Shipment Page of <br /> o be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? U Yes O No If no, what analyses are still needed <br /> 2) Was the report issued within the requested turnaround time? U Yes U No If no,what was the turnaround time? <br /> Approved by Signature _ Company <br /> r , <br />