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L -r <br /> c ❑ 680 Chesapeake Drive•Redwood City,CA 94063•(415)364 9600 ❑ 18939 120th Ave,N E,Suite 101 •Bothell,WA 98011 •(206)481 9200 <br /> 0E (3 819 <br /> Striker Ave,Suite 8•Sacramento,CA 95834•(916)921-9600 IDEast 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924 9200 a <br /> 1JN % flL (D ❑ 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686-9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 ry <br /> Company Name6 ,S- Protect Name wr f UIP C -(-nw V, I V <br /> Address 03-5 paC'ser )04"k ,,U� stip �G UNOCAL Protect Manager <br /> City rl" d6114 State Zip Code Release # C <br /> Telephone I( - 3I- 13/ FAX# (f �l - 131 Site # <br /> Re ort To 5T0C CC4r u•r iSampler J f` OC Data evel A (Standard) ❑ Level B ❑ Level C ❑ Level D <br /> a <br /> Turnaround ❑ 10 Working Days ❑ 2 Working Days ❑ Drinking Water ,�. Analyses Re uested <br /> Time ❑ 5 Working Days ❑ 24 Hours -U Waste Water n6` <br /> ❑ 3 Working Days ❑ 2 -8 Hours q401C,1A ❑ Other <br /> Client DatelTime Matrix # of Cont Laboratory <br /> Sample I ❑ Sampled Desc Cont Type Sample # q� r r Comments <br /> 1 -Z 7 a DI Ar-g <br /> C <br /> 2 a 0 <br /> 0 <br /> 4 0 <br /> m <br /> 5 <br /> 6 <br /> 7 55 <br /> a <br /> 9 <br /> 10 <br /> m <br /> 0 <br /> co <br /> 1 —J <br /> Relinquished By ate 7= 5 Time Received B Date Time �,rf'J <br /> m <br /> Relinquished By Date Time �D Recetya ry Date Time <br /> elrn uishe Date Ttme Received B Lab D eZ � Time <br /> Wee Samp es Received in Good Condition Yes O No Samples on Ice? 'Yes 0 No Method of Shipment Page of <br /> z o be completed upon receipt of report f <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes❑ No If no, what analyses are still needed? <br /> ' 2) W the report issued within the requested turnaround time? ❑Yes❑No If no,what was the turnaround time? <br /> Approve Signature Company <br />