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X1680 Chesapeake Dnve-Redwood City,CA 94063-(650)364-Nm J 18939120th Ave,N E Suite 101 •Bother] WA 98011 •(206)481-9200 <br /> UNOCAL <br /> ❑B79 Stnimi Ave. Suite 8-Sacramento,CA 95834-(916)921-9600 Cl Past 11115 Montgomery,SUite B-SPokane.WA 99205-(509)9249200 <br /> ❑404 N WYrget Lana•ftnut Cheek,CA 94598-(925)988-9600 0 15056 S W Sequela Pkvry,Suite i10•Pcirtlatid,OR B7222•(503)6243$@0 <br /> _ 1 1455 McDowell Blvd North,Suite D-Petakmta,CA 94854•(707)792-1865 <br /> Consultant Company �N✓�rr.�►J w✓ ,'-,r;"VS i'.,c_ Project Name- , <br /> Address, 7JL�`7 <br /> 3 1C t 00 UNOCAL Project Manager <br /> } City r 6vorTt) State- } Zip Cade 4,14 AFE- #- <br /> Tale hone <br /> A $'Z- FAX Site#, City,State. b I 2' Sib c <br /> 41 <br /> Report To: �t.� Sampler. div L f QC Data el D{smntrQ U Level C 0 Level B ❑Level A v <br /> Turnaround 10 Work Days 0 5 Work Days U 3 Work Days Q Dnnkirig Water Analyses Reques—ted � <br /> Tinw ❑ 2 Work Days U 1 Work Day LI 2-0 Flatus iL <br /> D Waste Water <br /> CODE: t3 Misc Q Detect. ©Eval ❑Rerned. ❑Demol Ct Closure W01her <br /> Client Date1T[me Matrix #of i Cant Laboratory r' + <br /> Sample I.D. Sampled De5C Cont Type Sample# 4 Comments <br /> 2 11) o0 0 0 <br /> n <br /> Il 4 3 <br /> i o <br /> I 6 <br /> 7 ! } IlN ACC <br /> &- C <br /> EEEI <br /> 9 �. <br /> 10 0 0 <br /> 12 <br /> ZI <br /> Relinquished By4 Date Time Received By Dale Time �rZ <br /> Relinquished By - Dateaf4- Time f Received By.. <br /> Date- Time � <br /> Relinquished By Date Time- Received BY La Date�� Time <br /> Were Samples Received In Good Condition? ❑Yes 011a Sampies on ice? (3Yes ❑No me of Siliprnent Page Z of Z <br /> To be completed upon receipt of report <br /> 1)Were the analyses requested an the Chain of Custody reported? Q Yes ❑No If no, what analyses are still needed? <br /> 2)Was the report Issued within the requested turnaround tirne? U Yes O No If no,what was the turnaround time? <br /> Ask <br /> Approved b atur om =4 17aM <br />