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i ❑ 680 Chesapeake Dave•Redwood City,CA 94063•(415)I 364 9600 ❑ 18939 12011 Ave,N E,Suite 101 •Bothell WA 91011 *,201,,4111 9200 UNOCAL D (D,819 Striker Ave,Suite e-Sacramento CA 95834•(916)921-9600 Ll East 11115 Montgomery Suite B•Spokane WA 99206•(509)924 9200 ❑ 404 N Wiget Lane•Walnut Creek,CA,94598•(510)988-9600 ❑ 15055 S W Sequoia Pkwy,Suite 110-Portland OR 97222•(503)624 9800 f Consultant Company Ce -? a C, Project Name vtaccA --�i Ot 8-7 Address 3 ktaq C- olS Ca llpDrive S'L Ae_ 240 UNOCAL Project Manager NkGk kC_ Sa h Clty e�q nct„p Ca rt�a va State CA ZIP Code lq " 74 AFE# In� C Telephone (q 16 63' - ISOO FAX# (gl61 631- 131-7 Site#,City, State 4 ls-7 6 -Ua,n elm v Report To v Za Sam ler 0vi 4'; l�lf 11 QC Data Level D (Standard) ❑ Level C ❑ Level B I� Level A C Turnaround Q 10 Work Day ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water Anal ses Re uested a Time 2 Work Das 1 Work Da ❑ 2-8 Hours ;I ,I I] Waste Water CODE: LJ Misc F-) DetectC) Eval L) Remed L) Demol 13 Closure ❑ Other - Client Date/Time Matrix #of Cont L''aboratory Sample I D Sampled Desc Cont Type Sample# Comments y a %C.'_1 l �CWJJ nv�-bl � ,LI 11016 0 2 3 r a S1 4 ! o 5 C 6 I jf 7 iLOA it ItIn U 10 7F71 M 0 Relinquished By Date - UV Time T/tr Received B v Date 11-Y& Time11 - Relinquished By ` L_ ��0 Date //-�-OU Time /Jf J Received S Date 1�� 00 Time Neluu rushed By Date Time I Received By Lab I Date ITime Were Samples Received in Good Condition? Yes U No Samples on Ice? 4 Yes U No Method of Shipment -~�_�(��! Page - of _ To be completed upon receipt o report 1) Were the analyses requested on the Chain of Custody reported? kiYes U No If no, what analyses are still needed? 2) Wast Mort issued within the requested turnaround time?.ksfYVlt�at was the turnaround time? Appiovacl by c t� 2 Signature O Company GAr_R d-^ JhL Date */�o