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UNOCAL <br /> U 680 Chosapoako Drive•Rodwood City,CA 94063•(650)364 9600 U 18939 120th Ave,N E Suite 101 •Bothell WA 98011 •(206)481 9200 <br /> U 819 Striker Ave, Suite 8•Sacramento, CA 95834•(916)921-9600 U East 11115 Montgomery,Suite 8•Spokane,WA 99206•(509)924 9200 <br /> 1404 N Wiget Lane•Walnut Creek,CA 94598•(925)988 9600 ❑15055 S W Sequoia Pkwy Suite 110•Portland,OR 97222•(503)624-9800 <br /> U 1455 McDowell Blvd North Suite D•Petaluma,CA 94954•(707)792-1865 <br /> Consultant Company GE 1 TL — N�' Project Name F0ffM R U,UO Ca L & 0t8'r- 5T-OCKTOU <br /> Address Gq Ct- 5ul� T UNOCAL Project Manager 13 <br /> 0 6 au S <br /> City Du B L State C Ft Zip Code 4-3 6 X AFE # <br /> Telephone °�5 1 ! 5 rJ. 5' FAX # 5 j _ Site #. City, State 3 7 E-65 r n�1 c-fl iws - <br /> Report To ff LV() Sampler VO QC Daia evel D (Standard) ❑ Level C ❑ Level B ❑ Level A v <br /> Turnaround ❑ 10 Work Days Work Days C23 Work Days ❑ Drinking Water Analyses Requested <br /> a <br /> Time LJ2 Work bays 'QI Work bay ❑2-8 Hours ❑Waste Water ra( <br /> CODE: ❑Misc ❑Detect ❑Eval ❑Remed ❑bemol L1 Closure bZOther1-f— <br /> Client Date/Time Matrix # of Cont Laboratory Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> t Co+f _S(�h 13 SO i LF-5ru �5 90 000 v ✓ o <br /> T <br /> 0 <br /> 2 � <br /> 3 <br /> J <br /> 4 0 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 0 <br /> 10 0 <br /> fit If <br /> Relinquished ByAw[AI zo�10Date3 ( Time �j, Received By f Date ��3t'l Time <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? Wes ❑No Samples on Ice? ?�(es ❑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? ❑Yes ❑ No If no, what analyses are still needed? <br /> 2)W e report issued within the requested turnaround time? ❑Ye1W No If no, what was the turnaround time? <br /> Approved Signature Company <br /> P Y <br />