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— "'"'eaapeaKeunae•nteUWuc)oUlly,UA 404UNi•(415)3649600 U 18939 120th Ave,N E,Suite 101 •Bothell,WA 98011 •(206)481 9201) <br /> U N@ C A L ID Q 819 Striker Ave,Suite 8•Sacramento,CA4•(916)921-9600 Q East 11115 Montgomery,Suite B•Spokane,WA 992060)924 9200 <br /> Ll 1900 Bates Ave,Suite LM•Concord,CA 9101.(510)686 9600 ❑ 15055 S W Sequoia Pkwy Suite 110•Portland,OR 97222•(503)624 91300 <br /> Company Name e0 S4rc , 1 5 Project Name c�+�Z�- oq <br /> Address UNOCAL Project Manager 106 Tid-c1Sf— <br /> City Amc)40 C LVA State CA Zip Code Release# <br /> Telephone - {3Oa FAX# 631--1 317` Site# O 1Q� x{37- �", / Mer, { <br /> //�� U <br /> Report To �-�' Sam ler S"-LFA 4-e� QC Data Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround �6 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water JAnalyses Requested o <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE ❑ Misc 'Al Detect ❑ E;val ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Date/Time Matrix #of Cont Laboratory <br /> � \ <br /> Sample I D Sampled Desc Cont Type Sample# \� �j �0 Comments <br /> o <br /> 2 US <br /> O <br /> 3 u% -yo N,VISI <br /> 45S1A <br /> 5 <br /> 6 <br /> 7 <br /> B <br /> 9 <br /> 10 <br /> 0 <br /> 0 <br /> s0 <br /> Relinquished AB <br /> e <br /> � Time = � Received B Date7,3 J J Time <br /> , <br /> Relinquished Date 3l Jv <br /> Time/,-220 Received B Date Time <br /> Relinquished Date Time Deceived 13 Lab ate Time ,7� "" <br /> Were Samples Received in Good Condition'? Yes❑ No Samples on Ice? Yes❑ No Method of Shi menO—f616/✓a Page of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes Q No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes IJ No If no, what was the turnaround time? <br /> Approved by _ Signature Company Date <br />