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❑ 680 Chesapeake Drive-Redwood City,CA 94063. 415)364-9600 ❑ 18939 120th Ave,N E,Suite 101 -Bothell,WA 98011 -(2 481 9200 <br /> • ��819 Striker Ave,Suite 8-Sacramento,CA 95(916)921-9600 ❑ East 11115 Montgomery,Suite B-Spokane,WA 99206-(624-9200 <br /> UNCAL <br /> ❑ 1900 Sales Ave,Suite LM-Concord,CA 94520-(510)686 9600 ❑ 15055 S W Sequoia Pkwy,Suite 110-Portland OR 97222•(503)624 98W <br /> I <br /> I <br /> ompany Name G , Project Name U ncc0., V dlf37ddress 3164 Go1S Cx p,n � Sulk. Zqp UNOCAL Project Manager ��c Ntc�erso,n <br /> City .,G[,.P Co j,.� State GN Zip Code 9S6 70 Release# <br /> c <br /> N <br /> Telephone 61 rb 6 3 l - 130V FAX# (916) 631 - 13 17 Site# D 18-7 C 0 <br /> Re ort To 1 JavX04 t4eC 7.0A Sam ler ick t f'Z QC Data Wr Level D(standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround i] 10 Work Days C) 5 Work Days ❑ 3 Work Days ❑ Drinking Water JAnalyses Requested I <br /> a_ <br /> Time 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other ��0 p��0� Q <br /> Client Datefrime Matrix #of Coni Laboratory Ou I <br /> Sample I D Sampled Desc Cont Type Sample# /� r� .��' �. Comments <br /> y rr 1L � <br /> 1 V - IS -SG 40130140/10 W 5,l 1 '6m%Gm I f5 IC - 1t -\ lAn rQlu- 0 <br /> 2 U - IS - 6 1 I041 K X X 8260 <br /> 3 o - IS - 66roSo l �( _J <br /> 0 <br /> 4 U - lS - ']! LOSS X X x- <br /> 5 U - t5 - 7JI l l }( <br /> 6 v- IS - 160 120a <br /> 7 /1220 L� X <br /> s 0 - 15 / 1317 <br /> 1317 ( )( <br /> 9 v- f5 101 1325 X ?c X ��) z <br /> 10 V - IS - la 6 1 360 201 <br /> ro <br /> m <br /> Relinquishe Tirnl( Received Dat o,� 1me <br /> Relinquished B e191te37-06 -KnW Received By Date f Time �5 <br /> Relinquished By I Date Time Received By Lab I Date ITime <br /> Were Samples Received in Goad Condition?Cl Yes❑No Samples on Ice? ❑Yes O 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 reported9 ❑Yes❑No If no,what analyses are still needed? ------- --- --------- <br /> 2) Was the report issued within the requested turnaround time? ❑Yes❑ No if no,what was the turnaround times --- ----- --- <br /> Approved by __ _ Signature — Company _ _ Date <br /> I <br />