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UNOCAL <br /> ❑680 Chesapeake Drive•Redwood City,CA 94063•(650)364-9600 El18939 120th Ave, N E Suite 101 •Bothell,WA 98011 •(206)481-9200 <br /> ❑819 Striker Ave,Suite 8•Sacramento CA 95834•(916)921 9600 ❑East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> 0 404 N Wlget Lane•Walnut Creek,CA 94598•(925)988-9600 0 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> ❑1455 McDowell Blvd North,Suite D•Petaluma,CA 94954•(707)792-1865 <br /> Consultant Company s s Project Name Z ,,rl <br /> Address ;z>' + r � UNOCAL Project Manager <br /> City 1,roV rj� State Zip Code AFE # <br /> Telephone FAX# Site #, Cl State �t� � C _m D 7?I 0 <br /> Report To CL419, �y c.�f Sampler n� QC Data XLeVel D (Standard) 0) 0 Level C ❑ Level B Level A v <br /> Y <br /> Turnaround 010 Work Days ❑5 Work Days X3 Work Days ❑ Drinking Water Analyses RE;quested a <br /> Time ❑ 2 Work Days ❑ 1 Work Day ❑2-8 Hours p Waste Water <br /> CODE: ❑Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑Closure AOther <br /> Client Date/Time Matrix # of Cont Laboratory �1 4. /Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> 1 �2_ �—� f zl`5� Z arc, f,'� XX X- �us�� <br /> a <br /> 2 0 <br /> 3 <br /> 4 , OLER CUSTODY S INTA1,70 NOTINTACTO o <br /> 5 COOLERTEMP ATUR QG <br /> } <br /> 6 <br /> 7 <br /> 8 <br /> s <br /> 0 <br /> 0 <br /> 10 <br /> Relinquished By / Date Time Received By DcTime <br /> _ s <br /> Relinquished By Date �"• Time Received By Date Time 3: <br /> Relinquished By Date Time Received By Lab Date c,6 Time �,,r 3X' <br /> Were Samples Received in Good Condition? ❑Yes ❑No Samples on Ice? ❑Yes ❑ No Me of Shipment _ Page— -of <br /> To be completed upon receipt of report <br /> 1)Were the analyses requested on the Chain of Custody reported? ©Yes ❑ No If no, what analyses are still need ed? <br /> 2)Was the report issued within the requested turnaround time? 0 Yes 0 No if no, what was the turnaround time? <br /> pPr SigNme —dWI at& <br />