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© 690 Chesapeake Dnve-Redwood City,CA 94063-(415)364-9600 ❑ 18939 120th Ave,N E,Suite 101 •Bothell,WA 98011•(206)4819200 <br /> UNOERL (D ❑ 819 Striker Ave,Suite e-Sacramento,CA 95834-(916)921-9600 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> ❑ 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686-9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Company Name Project Name <br /> Address 3035 ?ros cx J- Ta,,k NI ske F0 UNOCAL Project Manager --r't; ,, C-1r <br /> City '�Ot c—" State CA Zip Code `5 q- Lr M I`h <br /> Telephone e 3 / -- / /Lf FAX# 651- 13'17 - Site# d 19 7 <br /> ,Report To �5�e_ Sam [er QC Data Level A (Standard) ❑ Level B ❑ bevel C ❑ level D U <br /> Turnaround 1 10 Working Days ❑ 2 Working Days ❑ Drinking Water JAnalyses Re nested CL <br /> Time- ❑ 5 Working Days ❑ 24 Hours ❑ Waste Water <br /> ❑ 3 Working Days ❑ 2 -8 Hours ❑ Other . 911 <br /> Client Date/Time Matrix # of Cont Laboratory ( � V <br /> { 1 Sample I D Sampled Desc Cont i Type Sample # \e �,� Comments <br /> 2 u S - I.5 —6-1 F 010 <br /> !! r L XCr <br /> 5 <br /> 7 <br /> 8 IAL 7-5.5 -b�q fz•tv u <br /> 9 JAL - �5•S -&,-yy rZ-•�� <br /> 10 15 --b-y� ly•SS C� �C <br /> iT <br /> Relinquished By Date Time D Received B Date�j / Time / ) <br /> i <br /> Relinquished By Date 7// Time/S-6 D Received B Date Time <br /> Relinquished Bv Date ITime lReceived By Lab I Date Time 1 O <br /> Were Samples Received in Good Condition? P-YL3s❑No Samples on Ice? V'Fes© No Method of Shipment Page V of - <br /> o be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? 0 Yes 0 No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? 0 Yes ❑No It no, what was the turnaround time? <br /> Approved Signature Amk Company p <br />