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0 580 Chesapeake Detre•Redwood City,CA 94063-(415)364-9600 O 18939 120th Ave,N E,Sude 101-BodW,WA 98011•(206)481-9200 <br /> UNOCHLO 0 819 Striker Ave,SLute 8-Sacramento,CA 95834•(916)921-9600 ❑ East 11115 Montgomery,Sate B-Spokane,WA 99206•(509)924-9200 <br /> O 1900 Bates Ave,Suite LM-Concard,CA 94520•(510)686-9600 fl 15055 S.W SeWom Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Q <br /> Company Name T <br /> �fl J <<�R r l 1 .�1C Protect Name 7 z , 0 3 i <br /> ddress ' t1 UNOCAL Project Manager f r~� tl cct° <br /> City- "�'A'v i State rp Code 6-15"(,_10 <br /> Telephone /�'� ! ��� FAX#f- 6 j! - !'�! L:Data. <br /> Cr el c~n <br /> Re r1t To i'�` �.��' � ISampler i�U c i 4+-� 14 Level A(standard) ❑ Level B ❑ Level C ❑ Level D U w <br /> x <br /> Turnaround ❑ 10 Working Days ❑2 Working Days ❑ Drinking Water [Analyses Re ue7e_d (L <br /> Time: )45 Working Days ❑ 24 Hours ❑ Waste Water m <br /> b3 Working Days ❑2 -8 Hours ❑ Other ��1� \a� Ln <br /> Client Datefrime Matrix #of Cont Laboratory <br /> �- <br /> Sample 1 D Sampled Desc Cont Type Sample # Comments 0 <br /> ,'t4t --0364 `4 0-1 <br /> 2 �> Cr L <br /> m � <br /> 3 <br /> 4 2 <br /> — m <br /> 5 ` r <br /> CD <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> Q <br /> Relinquished By , % { ,; fr r, _ « .G- -- Date-7 -1 SrI Time f ID Received R -Date "/>, : Time <br /> Relinquished 13y" Date Time Received By Date Time <br /> Relinquished B • I Date ITime I Received By Lab I Date ITime <br /> Were Samples Received in Good Condition?❑Yes❑No Samples on lee? ❑Yes❑No Method of Shtpment Page_of r o <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 O No If no,what was the turnaround time? <br /> Approved b Signature Company Da <br />