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0 580 Chesapeake Drive•Redwood Crly,CA 94063•(415)364-9600 0 18939120th Ave,N E,Suite 101•Bottvell,WA 98011•(206)481-9200 <br /> UNOERL O 819 Striker Ave,Suite 8•Sacramento CA 55834-(916)921-9600 O East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> 13 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686-9600 O 15055 S W Sequoia Pkwy,Slice 110•Padw d,OR 9722.2-(503)624-9800 <br /> CD <br /> rddress <br /> mpany Name 1 -ie c 1 ] 1 �!C Project Name 2 } L A <br /> - JS lac S e i I�tL, { } � j , �d UNOCAL Project Manager 7t rLJ Q <br /> City I-t 0 6+�lkYc State CA Zip Code �Sd�� �j ��r►l r Y `f <br /> Telephone FAX# (17 17 Site#. 61 ' m Ln <br /> ff U cn <br /> Report To � t v�- L tit rbr FSampler '51--F Af-- QC Data b Levet A(Standard) ❑ Level B ❑ Level C ❑ Level D <br /> Y <br /> Turnaround ❑ 10 Working Days ❑2 Working Days ❑ Drinking Water lAnalyses Re uested oc" <br /> Time: ❑ 5 Working Days ❑ 24 Hours ❑ Waste Water <br /> Da u� � U) <br /> ❑ 3 Working Days ❑2 -8 Hours ❑ Other ( � Q � , � I <br /> Client Date/T-ime Matrix #of Cont Laboratory Ati J u{ <br /> Sample I D SampI Desc Cont Type Sample# 17 Commentsrn <br /> 1 U 1k1 - z 5 > �Ia-y� ►5 �t i ; o u <br /> a <br /> 3 U{I L1 .5 - 4 I; 1�; \1V w <br /> 4 i 5 - -��j sC r K, A X 0 ID <br /> 5 } <br /> I 6 �I <br /> 7 <br /> 8 <br /> 9 <br /> LU <br /> 10 j <br /> Cr <br /> Relinquished By j r{ i f te! t .- Date 7-If-9`/ Time f /0 Received Date( 1i A:c./Time <br /> Relinquished By Date Time Received By_ Date Time <br /> Relinquished B Date ITime t Received By Lab Date rrime <br /> Were Samples Received in Good Condition❑Yes 0 No Samples on Ice? El Yes O No Method of Shipment Page_of <br /> To be complete3 upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes 0 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 Dat <br />