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Q 680Chesapeakeanve-Redwood City,CA 94063-(415)364-11, 1 18939120th Ave,N E,Suite 101 -Bothell,WA 98011-(206 481-9200 <br /> UN(*A L r U 819 Striker Ave,Suite S•Sacramento,CA 95*916)921-9600 ❑ East 11115 Montgomery,Suite B-Spokane,WA 99206-( 4-9200 <br /> C1 1900 Bates Ave,Suite LM-Concord,CA 94520-(510)686-9600 ❑ 15055 S W Sequoia Pkwy,Sude 110-Portland,OR 97222-(503)62A-98M <br /> Company Name CsG4TdE�� Project Name , <br /> e ernlG Grp .Sttr.G[ 5rx7WN 01 <br /> Address .3/6� C9o�a �Yo UNOCAL Project Manager a 8mur�— <br /> City ZW,,w State �� Zip Code 9r-r.7,e Release# <br /> c <br /> Telephone C116)6,51- 1300 FAX# fisc �5/-falx Site# 7aZ7 21 <br /> U <br /> Report To cgc �a,cs Sam p I e r / A'-r�c QC Data J� Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround 1$j 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water [Analyses Requested <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Datef ime Matrix #of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# /�° Comments <br /> .54fX f k O <br /> 2 Snl-t3 0 <br /> 3SP/— a <br /> 45�/� d o <br /> 5 <br /> 6 <br /> 7 <br /> 9 <br /> 10 T 0 <br /> 0 <br /> Cd <br /> Relinquished By Date S;-.?o rime �'c` Received B Date �( " , - TimeReceived cA- J <br /> m <br /> Relinquished B Date 4 ime <br /> q Y g ���� B Date�U Time 0 <br /> Relin <br /> ZL" <br /> Relinquished B DateI L' J <br /> �2 �7 Time 10q0 lReceived Bk Date Time )0� <br /> Were Samples Re ived in e0od Condition? Yes O No Samples on Ice?XyesONo Method of Shipment SSC-C-7t101 W Page_of <br /> Ibe completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes O No if no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? 1:1 Yes 0 No If no,what was the turnaround time? <br /> Approved by <br /> Signature Company Date <br />