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0 680 Chesapeake Drive.Redwood City.CA 94063-(415)364-9600 0 18939120th Ave,N E,Sutte 101-Batheq,WA 98011-(206)481-9200 <br /> UNOCRL (D <br /> ❑ 819 Sinker Ave,Surte 8-Sacramento,CA 95834-(916)921-9600 C1 East 11115 Montgomery,SWe B-Spokane.WA 99'106-(509)924200 <br /> 9 <br /> ❑ 19o0 Sates Ave,Sugte LM-Concord,CA 94520-(510)686-9600 ❑ 15055 S W Sequoia Pkwy.&AG 110-Portland,OR 97222-(503)624-%W <br /> m <br /> Company Name Project Name- 252, 6) � Q <br /> Address {�; �� y,r, { �, :c l�j S �i0 UNOCAL Pro)ect Managers}fits-,v Clu.� Q <br /> City -I`,;� ,, 1-Lt LtiC (;C State i - Zip Code ��r+ Q $ ri?�� #. n t': At-ttryi-, <br /> Telephone Ll FAX# "---/f - } %1 Site# t.`'1 [J m <br /> R ott To iii E`J�- -lt- � Sa ler ref Q ��'� r QC Data. CLevel A(standard) ❑ Level B ❑ Level C ❑ Level D <br /> Turnaround 10 Working Days (32 Working Days ❑ Dnnking Water [Analyses Requ­est7;;j EL <br /> Time, ❑5 Working Days ❑ 24 Hours ❑ Waste Water m <br /> ❑3 Working Days 132-8 Hours C3Other o <br /> Client Date/Time 1 Matrix #of Cont- Laboratory \J�� Comments m <br /> Sample I D Sampled Desc. Cont Type Sample # , <br /> Jw <br /> 2 Or <br /> -4 }i <br /> a { O N <br /> CD <br /> r ( <br /> a <br /> m <br /> 41 <br /> FFRehnzutshed <br /> hed By :>%r i�, i1,rr,. c-- Date t - :/_ `l Time i r� /U Received BL.- Date�'f,, ,c,• Time % m <br /> By Date Time Received By_ Date Time <br /> Relin--uished By Date Time I Received By Lab I Date ime: <br /> Were Sam. pies Received in Good Condition?O Yes O No Samples on Ice? Q Yes 0 No Method of Shipment Page of <br /> To be—cc-mi-pleted 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❑No If no, what was the turnaround time? <br /> Approved byAft Signature Company Date <br />