Laserfiche WebLink
:SMhesl�Drr�dwo� CAS• 96ts 18C Ilh AMES<_1 •Ba WA 0�920t_ <br /> rAr :18 19 Sinker Ave ,Suite e• Sacramento,CA 95834 •( +921 9600 ❑bast 11115 Montgomery,Suite B•Spokane,WA 994 (509)924-9200 <br /> V 0 404 N Wiget Lane•walnut Creek.CA 94598•(925)988 9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> G ;L� O 1455 McDowell Blvd North, Suite D• Petaluma,CA 94954 -(707)792 1865 <br /> Consultant Company Gz�1'�� �`Y' ' 1''G -4-6 y 7/ `'066 `FG ` 'f Project Name -SS <br /> Address ��� S���rc C:t,�.�� S�� ft UNOCAL Project Manager P,-, -A ,,b <br /> City Aa,a 1. n State C eA . Zip Code V G C AFE <br /> TelephonE(g�S) SSI - X3-5-� FAX (yLr}sr7- �'i 9 y Site , City, State s�U G X4.4 ��L ;QA?- <br /> Report To b1)pq► �. h Sampler t/t f�a a j�s A r �L,, QC Data—XLevel D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround ❑ 10 Work Days O 5 Work Days O 3 Work Days ❑ Drinking Water Analyses Requested <br /> Time 2 Work Days_, ❑ 1 Work Day ❑2-8 Hours ❑Waste Water { <br /> � <br /> CODE' ❑ Mlsc ❑ Detect ❑ Eval ❑ Remed 0 Demol ❑ Closure ❑ Other <br /> Client Date/Time Matrix 9 of Cont Laboratory ty� Comments <br /> Sample I D Sampled Desc Cont Type Sample 11 <br /> i r✓-Z I S G -o r1„ � _3 vl,,a S `C <br /> 3 P(��. Z Z S �� <br /> 4 M lv Z 2, C{ cit 3 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> Relinquished By ' Date J q Time Cl S Received By Date Time, <br /> Relinquished By Date Time Received By _ Date 6 18 1Jc7 Time- `/�� <br /> Relinquished By Date Time Received By Lab Date' Time <br /> 9re Samples Received In Good Condition? U Yes ❑ No Samples on Ice? U Yes ❑ No Method of Shipment Page I of <br /> be completed upon receipt of report <br /> 1) Were the analyses requested on the Cham of Custody reported? ❑Yes CJ No If no, what analyses are still needed? <br /> �)Was the report issued within the requested turnaround time9 L)Yes ❑ No If no, what was the turnaround time? <br /> id by Signature Company Date <br /> I <br />