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❑ 680 Chesapeake Drive•Redwood City,CA 946415)364-9600 ❑ 18939120th Ave,N E,Suite 101 •Bothell,INA 98011 •{ 481-9200 ' <br /> U N&A L (D O 819 Striker Ave,Suite 8•Sacramento,CA 9 (916)921-9600 ❑ East 11115 Montgomery,Suite 8•Spokane,WA 99206• 9249200 <br /> O 1900 Bates Ave.Suite LM•Concord,CA 94520•(510)686-9600 ❑ 15055 S W Sequoia Pkwy,Sude 110•Portland,OR 97222•(503)624 9800 <br /> Company Name Project Name GV> <br /> o e�C GUaC RL. Sr'.sav o/B <br /> Address 3�G l G�M� DEQ UNOCAL_Project Manager <br /> F,2r <br /> City ,v e/fff ea rho✓Is State C,& zip Code yZ-;o Release# <br /> Telephone 9��� 63/ 1360 FAX # yFle) 63'1-/3ig Site# o,t7 m <br /> ,71 U <br /> Re ort To <br /> C�.cEC- 6u,rss iSampler QC Data Level D (standard) ❑ Level C ❑ Level B ❑ Level A � <br /> Turnaround 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water lAnalyses Re uested <br /> Time ❑ 2 Work Das ❑ 1 Work Da 1:12-8 Hours ❑ Waste Water <br /> CODE- ❑ Misc ❑ Detect ❑ Fval ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Date/Time Matrix #of Cant Laboratory <br /> Sample i D Sampled Desc Cant Type Sample# a Comments <br /> 8-11-971offiq <br /> ° <br /> 2 U,- — ►� s l9 t� ofrl oca <br /> ` <br /> 3 <br /> 4 Lt- `r ' Z1 s' 8-►4-F7 �OoZ 3 <br /> 0 <br /> 31 /1010 IOU <br /> 6 LL- q-31,5' 6-11-111107 Q <br /> 7 U- 9- 3G f 6-0-9� /a iIV <br /> h4,l,A <br /> 8 _ <br /> 9 <br /> G1 <br /> 10 0 <br /> L <br /> 0 <br /> Relinquished By Date Time '40 Received B Date 9'1WIPTime IV.-M -� <br /> 0 <br /> Relinquished By Date ime Received By Date ilwhl 7 Time O <br /> Relinquished By Date Time Q Received B ab Date Q Time o <br /> Were Samples Recejed in G od Condition? Yes❑ No Samples on Ice?,(Yes 0 No Method of Shipment_ S�'�LfQ'� Page__ of <br /> To be completed upon receipt of report f <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes❑ No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes O No If no, what was the turnaround time? <br /> Approved by - Signature Company Date <br />