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❑ 680 Chesapeake Dnve•Redwood City,CA 940 415)364-9600 ❑ 18939120th Ave,N E,Suite 101 •Bothell,WA 96011 •( 481-9200 <br /> f Q 819 Striker Ave,Suite 8•Sacramento,CA 95 (916)921-9600 ElEast 11115 Montgomery,Suite B•Spokane,WA 99206.0924-9200 <br /> UN&AL <br /> Q 1900 Bates Ave,Suite LM•Concord,CA 94524•(510)686-9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Company Name eil& Ac, eL.ClG Project Name 7 a27, ,2 <br /> Address Cf 3 16C'c,/c/ Cam jo A, UNOCAL Project Manager /3GS '90"s y <br /> City 46ho rrt cVc- State Zip Code V,0$� Release# <br /> c <br /> Telephone q - PAX# �/3l-/�/7 Site# 14-Pk- ! rfv4 G7G� v <br /> Re ort To Sampler 10i 1QC Dataevel D (standard) ❑ Level C ❑ Level B ❑ Level A <br /> ri <br /> Turnaround .4<Work Days kKwork Days ❑ 3 Work Days ❑ Drinking Water Anal ses Requested <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Flours ❑ Waste Water �.��✓ �� <br /> CODE: ❑ Misc ❑-Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other 7 a <br /> Client Date/Time Matrix #of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> 6o 0 <br /> co <br /> co <br /> 3 <br /> J <br /> 4 0 <br /> a� <br /> 5 26 12 f a <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 0 <br /> co <br /> 0 <br /> Relinquished By Date � 7 Timed" Received B �' Date 2 Time y J <br /> Relinquished By at ime Received B Date Time <br /> Relm uished B Date Time Received B Lab Datei � to Time X65 <br /> Were Samples Received in Good Condition? ❑Yes❑ No Samples on lce?,�Yes❑ No Method of Shipment Page W <br /> To be completed upon receipt of report <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 0 No if no,what was the turnaround time? <br /> 'Approved by Signature Company Date <br />