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Lancaster Laboratories 1�s�8 For La caster Laboratories use only <br /> Where qualrtyr5ascrence Acct # � Sample# �to SGR# <br /> Analyses Requested <br /> Facility# Preservation Codes Preservative Codes <br /> H =HCl T=Thiosulfate <br /> Site Address o-6&:571 1t•5 A, ,xxy `tq N =HNO3 B=NaOH <br /> Chevron PM�b moo=Lti e y,,_ Lead Consultant x-,a2 S= H2SO4 O=Other <br /> ;n U <br /> aV ❑J value reporting needed <br /> Consultant/Office 3017 /e40/2Z �'u<y�i� Gokrl/v� ❑ (D <br /> c ❑Must meet lowest detection limas <br /> Consultant Pr) Mgr Tota _-S c LcSg--r. U C=c possible for 8260 compounds <br /> El <br /> 0 E3 <br /> Consultant Phone# Fax# o 8421 MTBE Confirmation <br /> N CD Cr N <br /> � <br /> co o o ❑Confirm highest hit by 8260 <br /> Sam pleF;---�, N E m 0 ❑ ❑Confirm all hits by 8260 <br /> Service Order# []Non SAR Lo Ln <br /> a Z + oo o ❑Run_oxy's on highest hit <br /> Field Repeat Top Time New M o oa a ElRun_oxy's on all hits <br /> Point Name Matrix iSamale De th Year Month Da Collected Field Pt 0 0 H m 1-_ 1-_ <br /> 4 — Comments I Remarks <br /> c: <br /> U` <br /> O LL G <br /> Relinquished b Date Time Rec Date Time <br /> Turnaround Time Requested (TAT)(please circle) ��"�`-� <br /> STD TAT 72 hour 48 hour Relinq Date Time Received by Date Time <br /> 24 hour 4 day 5 day <br /> Relinquished by _ Time Received by Da Time <br /> Data Package Options (please circle if required) <br /> QC Summary Type I—Full Relinquishe=edE, <br /> rcial Carrier Rec ived by ate Time <br /> Type A(Raw Data) ❑Coelt Deliverable not needed <br /> WEP(RWQCB) <br /> UPS Other � � YrI�Q�Y7 i�z oz �16s <br /> Disk [Temperature Upon Receipt Co Custody Seats Intact? Yes No 9 <br /> Lancaster Laboratories, Inc,2425 New Holland Pike PO Box 12425 Lancaster PA 17605-2425 (717)656-2300 3460 Rev 10/04/01 <br /> Copies White and yellow should accompany samples to Lancaster Laboratories The pink copy should be retained by the client <br /> I ' <br />