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UA L ❑ 819 Sinker Ave,Suile 8-Sacramento,CA 958 •(916)921-8640 ❑ Pas€111€5 Monlgornery,Suae 8-Spokane,LVA 99LW•( 924.9200 a <br /> C11 M Bates Ave,Surte LM-Concord,CA 9452 0)666-9600 a 15055 S LV Sequo�Pkwy,Suas 110-Portland OR 97222• 624-9800 <br /> Company Name ,� ��f n� Project Name (42,707 <br /> t <br /> Address 3 UNOCAL Project Manager Bop &u57' <br /> City t*1rJJC) State C Zip Gode fSO�i Release# F .J <br /> Telephone ! {� /� � FAX#. lf�`lP�/1311 Site# OW�� C/5] fe_-s t lt4)av <br /> Re art To ��' Sam ler QC Data ❑ Leve) D(S3andard) l Level C ❑ Level B ❑ Level A <br /> Turnaround ❑ 10 Work Days ❑$Work Days ❑ 3 Work Days ti 1 Drinking Water Analyses Requested <br /> Time J 2 ANork Das Q 1 Work Da ❑ 2-8 Hours I ❑ Waste Water �a/ � <br /> BODE- ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑Closure ❑ Other <br /> n. f <br /> Client DatelTlme Matrix #t of Cont Laboratory <br /> Sample I D Sampled Desc Cont I TYpe Sample# Comments <br /> 1. _rr - <br /> 2 a <br /> s <br /> 4 <br /> G <br /> 5 > <br /> 6 <br /> I <br /> 7 <br /> 8 <br /> 9_ <br /> _ rd <br /> Rellnquishe By Date� G7 Tlrne Received B Date- <br /> _7iTime <br /> Relinquished Date ince G- Received Brr � � Date ime ' <br /> Retinauished B 5Dale Time Received By La Date 12 L Time �o <br /> n Mere Samples Received in Good Condition'? 0 Yes❑No Samples on Ice?' / <br /> SXYeMethod of Shipment Page of <br /> --- <br /> To be completed upon receipt of report C1 d _ 12 <br /> 1; Viere the analyses requested on the Chain ar Custody reported? ❑Yes Q No if no,what analyses are stiti needed? – — <br /> 2) Was the report issued within the requested turnaround time? 0 Yes Q No It no, what was the turnaround time? <br /> Approved by- Signature Company Date <br />