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a <br /> * 680 Chesapeake Onve•Redwood City,CA 94063•(415)364-9600 U 18939 120th Ave,N E Suite 101 •Bothell WA 98011 •(206)481 9200 <br /> U N O CA LJ) O 819 Striker Ave,Suite 8•Sacramento,CA 95834•(916)921-9600 U East 11115 Montgomery,Suite B•Spokane WA 99206•(509)924 9200 <br /> O 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686 9600 ❑ 15055 S W Sequoia Pkwy,Suite 110 a PorUand OR 97222*(503)624 9800 <br /> Company Name 6e ttee— _ �! Protect Name &Ouv L o l <br /> r ��p 60/d C�W✓1 S1,[ "e 2- Q DNOCAL Protect Manager <br /> Address -3 ALK tcke+�sp <br /> City 9,4AIC1 p GAdD A State ( Zip Code q5(p Q Release# <br /> C <br /> a� <br /> Telephone [Me [ — 3 DC7 FAX# ,I �,� Site# 01$ S TOC k �'�; U <br /> Re ort To I/! e D Sampler 7d ' C�C� OC Data Level D (Standard) ❑ Level C IJ Level B ❑ Level A <br /> Turnaround 10 Work Das ❑ 5 Work Das ❑ 3 Work Dais �I <br /> Y Y Y ❑ Drinking Water [Analyses Requested <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-B Hours" ❑ Waste Water <br /> CODE: lJ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑1Clasure ❑ Other <br /> Client DatelTime Matrix #of Cont i Laboratoryl �?+ <br /> Sample I D Sampled Desc Cant Type, L Sample# /`� Comments <br /> 5SPATL,1 ( -2! - �� 0'3 N-% f �a� iii N1 <br /> 2 -2.1 s +4:5 5 1 — l I ti t� k gL(00 <br /> 't S J _J3u -Z .. �rr1, 5 �� II <br /> a� <br /> 5G� - 1-71.5 ' — o $ I L } <br /> 6 -21 81,S' --1 Z Zo 5 ; <br /> ,� ri <br /> - a /,70 5 I ii T <br /> S' � t <br /> f <br /> 9 -ZI -111.51 — ; 5 �� z <br /> 0 <br /> 10 U _Z - 5` — :54 S I it <br /> / <br /> _G Received B /4c � Date /� Time IJ <br /> Relinquished By Dake Time S` U 3� `t <br /> 1 ` � <br /> Relinquished By -� ��� Date Time lb LU^ Received P tett Time It,, <br /> v li i <br /> Rehn wished B Date € Time Received By Lab I Date ITime <br /> Were Samples Received in Good Condition?[ Yes U No i Samples on Ice?�J Yes U No Method of Shipment S P�"(/011 Page of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? U Yes U No It no, what analyses are still needed? <br /> 2) We report issued within the requested turnaround time? U Yes U no, what was the turnaround time? <br /> Approved Signature Company D� <br />