Laserfiche WebLink
4fi3• <br /> 04 880 k ■R Crty, 1 3VO M i M = = M <br /> Q 18839 120M Ave,N E Su11e 101 •8othetl,WA 98011 •(2OB) U4 <br /> Obaft7t O 819 Straker Ave.Suite 8■Sacramento,CA 95834•(918)921-9800 Q East 11115 Montgomery Suite B•Spokane,WA 09206.(509)g24-92W <br /> Q 404 N Wrget Lane•Walnut Creek..CA 84698■(925)9g8-8800ZI 75455 S W 5 cera P <br /> eq kwy,Suite 110-Portland,OR 97222•(503)624-$80o <br /> U) ❑1455 McDowell Blvd NorLh,Sufis 0■Petaluma,CA 94954•(707)792 IM <br /> Consultant Company_ 61.1v,�oN�K � J Prate Name. <br /> rax.rs � �,�.g o3 � <br /> Address <br /> 3 D�l..�a �1Z S �OO UNOCAL Project Manager. a �� <br /> M Crty Vy� State l4 Zip Code: APE#: <br /> o Telephone !�) _ �c� 1=AX# / _ �.� Site#,Crty,State_ +. <br /> Report To 4f W I-CLIC�t Sampler: QC Data- .'Level D(standard) t1 Level C ❑Level B O Level A U <br /> r <br /> Turnaround ` 10 Work Days ❑5 Work Days !]3 Work Days Q Drinlan W 'e <br /> S ater Analyses Requested s~ <br /> Time. ❑ 2 Work Days Ct f Walk Day O 2-8 Hours � <br /> a Wasts Water <br /> CODE: ❑mrsc ❑Detect 0 Eval 0 Remed ❑Demol ❑Closure ekr�of <br /> Cheat Date/Time Matrix #of Cont Laboratory <br /> %Sample I.D Sampled Desi Cant Type Sam�le# <br /> � Commarrts <br /> z. MWS r <br /> 0 <br /> 4 ' <br /> U <br /> a <br /> ►~- 5- m <br /> J B <br /> Q <br /> � l�iJ1 <br /> 7 <br /> O $ i <br /> E � ■ <br /> CE <br /> Relinquished By_ Date- Time Received By - - p& :�Z� <br /> �J/j-ti% Tme: �CS�o <br /> CD Relinquished By Date r-g-r-9Time- f p� Deceived By DateL <br /> Tme <br /> Relinquished By Date Time Received By � Dated Time <br /> m Were Samples Received m Good CandJtloill O Yes Q NO Samples on Ice' ❑Yes 0 No M t of ShiprnaM Wage <br /> j To be completed up-on receipt of report- <br /> 1)Were the analyses requested on the Chain of Custody reported? ❑Yes Ll No If no, what analyses are all needed? <br /> 2)Was the report issued within the requested lurnaraund times C1 Yes 0 No If no,what was the turnaround time? <br /> Approved by Signature Company Date <br /> i <br />