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❑ 680 Chesapeake Drive•Redwood City,CA 940#$15)364 9600 ❑ 18939 120th Ave,N E,Suite 101 •Bothell WA 98011 •{*249200 1 92b0 <br /> UN&AL , ❑ 819 Sinker Ave,Suite 8•Sacramento CA 95 (916)921 9600 ❑ East 11115 Montgomery Su1e B•Spokane WA 99206•( <br /> ❑ 1900 Bates Ave,Suite LM•Concord CA 94520•(510)686-9600 U 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624 9800 <br /> Company Name iie-fflez —94A ��IC Project Name �n�eL�4L 00/67 <br /> Address 31 o Id ifer pi�p P' r— . Sri i Q Z�{-Q UNOCAL Project Manager IVlGtC. 11�rL'J�e�rs�nJ <br /> City /4►�Cti p C d V State C4 • Zip Code 70 Release# <br /> C <br /> Telephone (WO o l—!30 0 FAX# Site# U <br /> Re ort To Rtf, Sam ler JOW 1 G G1-, OC Data MgLevel D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround"'tdl0 Work Das ❑ 5 Work Das ❑ 3 Work Da <br /> Y Y Ys ❑ Drinking Water JAnalyses Re nested <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Date/Time Matrix # of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# f�Q Comments <br /> 1 -Z5�- 8 1 aZ ao- :t S l j tj K mr <br /> ' 0 <br /> r' -Z 5�' s tS e Z W, -0 <br /> s <br /> S 1 <br /> �1D <br /> 9 <br /> m <br /> 0 <br /> Relinquished By ate 3-W Time 11` Received e Date l-:5-60 Time l f J <br /> _ m <br /> Relinquished Dat 3`6G Timer-SU Received B Date /- Time <br /> Relin wished BL Date Time Received B Lab Date Time <br /> Were Samples Received in Good Condition?qYes Li No Samples on Ice? Yes la No Method of Shipment wokt Page of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? U Yes a No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? L)Yes I-3 No If no, what was the turnaround time? <br /> Approved by Signature - Company Date <br />