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❑ 680 Chesapeake Drive-Redwood City,CA 940 )3649600 364 9600 U 18939 120th Ave,N E,Suite 101 -Bothell WA 98011 -(201 9200 UA L x`819 Striker Ave,Suite 8-Sacramento,CA 95$34 )921 9600 LJ East 11115 Montgomery Suite B-Spokane,WA 99206-(5G 4 9200 U 404 N Wiget Lane-Walnut Creek,CA 94598-(510)988-9600 U 15055 S W Sequoia Pkwy,Suite 110-Portland OR 97222-(503)624 9800 Consultant Company Q ic- - Project Name mocA L'W Q IS Address 4o f a prl ve. ut� 2q o UNOCAL Project Manager Q i c k N t c.i�"" City �h�, . o,,,,� State CA Zip Code '51 Igta 76 AFE# r c Telephone (q 16 6 3 d - 3� FAX# (q 16) 631- 13 t 7 Site#, City, State O 112 � 4 Smk-4w, CA . U Report To DA V9: ki�'r JSampler70AJ4 HAAC-;C 11% JQC Data_g Level D(Standard) ❑ Level C ❑ Level B ❑ Level A d Turnaround ❑ 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water [Analyses Re nested Time U 2 Work Das ❑ i Work Day ❑ 2-8 Hours ❑ Waste Water %1 CODE: I, Misc F.J Detect L) Eval L) Remed ❑ Demol ❑ Closure L) Other fb0 `7O <) Client Date/Time Matrix #of Cont Laboratory0V Sample I D Sampled Desc Cant Type Sample# �q �'�' \� Comments j -- (p -16.+ 10/40 0— ca 3 Ut -1(0 -t , ;t "1! SS X jfFn Ce 4UI—II0 --Z(,s� 6 tA—lu— 31. Sr tL« X X X 7 u—l(o —3b.5 -MM3 8 -1116 -4 l 5' - !2.•3Z x x x g A - 1(0-%.51 — 112 ¢z X 10 (x—1k, ca Q -] cC Relinquished By _ Date OD Time g.UD Rec ved B Timel6ab3 � -' G, Relin lied By at TO'�� Recewe t Da cojI T imeZL Rehn uish D im �LJ Received B Lab Date 1 Time Were Samples Received In Good Condition?U Yes U No Samples on Ice? ❑Yes❑No Method of Shipment Page—of To be compteted.upon receipt of report 1) Were the analyses requested on the Chain of Custody reportede) U Yes U No If no, what analyses are still needed? 2) Was the report issued within the requested turnaround time? U Yes U No If no, what was the turnaround times Approved by __ ___ Signature _ __ _ Company _ Date