Laserfiche WebLink
❑ 680 Chesapeake Drive• O 18939 120th Ave.N E,Suite 101 •Bothell,WA 91301),• 481 9200 <br /> 1 (819 Stnker Ave,Suite 8•Sacrarrminto,CA 95 •(916)921-9600 O East 11115 Montgomery,Suite B•Spokane WA 99206• 9249200 <br /> U CAL ❑ 1900 Bates Ave,Suhe LM•Concord,CA 94520•(510)686-9600 a 15055 S W Sequoga Pkwy,Suite 110•Portland OR 97222•(503)624 9800 <br /> Company Name Ge #e r_ liti[, Project Name U 1111 o 0,A *b 16-7 <br /> Address 31(,� Gal (�OL UNOCAL Project Manager NCV t 5a <br /> City �, ��r p�A State to Zip Code 6-Ib Release# <br /> c <br /> Telephone ( 11,6 b S I - 13ab FAX# (916){`11b3_1 -_ 131-7 Site# o 18`T s6 ctAr n CA <br /> Report To 0&"tb ISampler QC Data Level D (Standard) ❑ Level C ❑ Level B ❑ Level A C: <br /> Turnaround [k 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water JAnalyses Requested a- <br /> Time IJ 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours ❑ Waste Water <br /> CODE: IJ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Dale/Time Matrix # of Cont Laboratory V <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> 106 }rr °� t (t? Sol ( t 6%Cote S l Q- "AD <br /> - ZS 110 -0 <br /> /" Zq I i I I <br /> 3 0- 23 - 120 1 +S6 X J <br /> 5 U v -3 - I I 1 t t5 CRL1 X <br /> 6 1,v -3 16 1 1112,0 <br /> 7 OV - 3-zl riz6 X X <br /> 9 <br /> 10 <br /> 0 <br /> 0 <br /> _ ro <br /> Relinquished By Date --- U Time /J_0T Received B Date//-�-Ut Time / I t' 1 -t <br /> Relinquished By ��f' Date//- -G(/ Ttme /6Dr� Received B l C 6 Time 1(7— E <br /> Relinquished By I Dale ITime I Received By Lab Date Time <br /> Were Samples Received in Good Condition?l/Yes U No Samples on Ice? [/Yes FJ No Method of Shipment S t'W <br /> zA1 Page—of <br /> I <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? U Yes U 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 Date <br />