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ve• od 94 50 00 yis ve, uun <br /> �'t 68*gape r ast 1 ve a ,Su pok A 9 94200 <br /> 0 619 Striker Ave, Suite 8•Sacramento CA 95834•(916*60'0 9 <br /> Ll 404 N Wiget Lane•Walnut Creek CA 94598•(925)988 9600 ❑15055 S W Sequoia Pkwy,Suite 110•Portland,OR 972 •{5t>'� 9800 <br /> O 1455 McDowell Blvd North,Suite D•Petaluma,CA 94954•(707)792 1865 <br /> GeAfv A'y I �rrr eV �d� / ss # sv 9 <br /> Consultant Companycin �►1G, ���Z�v�• � � Pro ect Name <br /> S <br /> Address S ie1'ia UNOCAL ProIect Manager rlr. gob. I30 s <br /> City bl/ State C,a zip Code ggj-4,? AFB If <br /> FAX 5'S- Site #, City, State -5-,6o6 /!Q• S " v <br /> Telephon 9ZS) .g-rl— -�S'.� ` `�9 Y �Q�► i 4 <br /> !tork <br /> U <br /> Report To � „q ampler Val Tes �j' OC Data � Level D (Standard) 0 Level C ❑ Level B ❑ Level A <br /> x <br /> Anal ses Requested <br /> Turnaround 10 Work Days Days ❑3 Work Days 0 Drinking Water YIL <br /> Time 2 Work Daysrk Day 0 2-8 Hours 0 Waste Water <br /> CODE: 0 Misc U Detect U Eval U Remed U Demol U Closure U Other \� D� <br /> Client Date/Time Matrix # of Cant Laboratory R�t� tib Comments <br /> Sample i D Sampled Desc Cont Type Sample# �g <br /> xorm ���' 2 � y 906157` o <br /> 2 w- �� Li M ti Z 90625'73 <br /> a w r� s �' N 4 Z k 061574 3 <br /> s w - ZIStq, P,, Z ti 90615'76 } <br /> s- - ZI !1 33'pr�t z k 90615'7'7 � <br /> MU, 225 � �►� 1- .� 90625'7 3 <br /> S µ - <br /> 2-7--DS <br /> 0 <br /> 9 <br /> 0 <br /> 10 A L ro <br /> r � <br /> Relinquished By Dated /� Time ,1S Received By Date (o-�(( Time ,fir <br /> Relinquished By �.Q,e C 4-c� Date (v J Z'qr Time Received Sy Date 4 Time �_'� <br /> Relinquished By Date Time ('7613 y La Received B 'r DatI��99 Time lc?:404 <br /> Were Samples Received in Good Condition? U Yes 0 No Samptes on ice? ❑Yes U No Method of Shipment Page-L-01 2— <br /> To <br /> -To be completed upon receipt of report <br /> 1)Were the analyses requested on the Chain of Custody reported? ❑Yes Q No If no, what analyses are still needed' <br /> 2)Was the report issued within the requested turnaround time? U Yes ❑ No If no, what was the turnaround time? <br /> Approved by _-- --� Signature _ _-- _-- - -- Company -- Date <br />