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❑ 680 Chesapeake Drive•Redwood City,CA 11416 15)364 9600 ❑ 18939 120th Ave,N E.Suite 101 •Bothell,WA 98011 •(2 1 9200 ❑ 819 Striker Ave,Suite 8•Sacramento,CA 95 10)1(1916)921-9600 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99206•(5 24 9200 UNo AL (D ❑ 19D3 Bates Ave,Supe LM•Concord,GA 94520•(510)686 9600 ❑ 15055 S W Sequoia Pkwy Sude 110•Poilfartid OR 97222•(503)624 9800 Company Name 6.e46r — 2 o n i A Protect Name Address 3 l qd C--,oU Cc,, ,,,,a r s tie sot k 1-70 UNOCAL Project Manager N t cv- kA k c\c-e C 5,,r City Ru n c k o (a rd o vu State CA Zip Cade �{S6-70 Release# Telephone (9 f6) 631 - 136'6 FAX# 010C-31 —— 1317 Site# ZOG9 56 oe% CA � r �.�is Hle QC ©ata Level D (standard) ❑ Level C ❑ Level B ❑ Level A c Re ort To u r� �-�cr za Sam ler 0. Turnaround P00WorkDays ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water JAnalyses Requested Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours 0 Waste Water CODE: U Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other l�oV.° Client Date/Time Matrix # of Cont Laboratory �V Comments Sample I D Sampled Desc Cont Type Sample# JR4 Z, Core S� , X 0 2 MW - 14 - 6o.-� ►ao8 1 X o 3 Mu, - 19 - 66 1013 X IL 4 1v,w - 19 --71 ro 18 X 6 Mu - 1a 7 MIu 19 - a6 /Iola a rAW- 19 9 Z 0 10 `o a I—A1 Time �r'6U Received i3 +! I Date � Time 1/ U Relinquished By Date 21 u f1elingwshed By Dat4 Time rl Received B ' 4 to43QJ()!Time Resin utshec}/ Date Time Received B Lab Dale Time Were Samples Received in Good Condition?❑Yes O No Samples on Ice? ❑Yes❑No Method of Shipment Page_of A To be completed upon receipt of report - 1) Were the analyses requested on the Chain of Custody reported? 0 Yes❑No if no,what analyses are sail needed? 2) Was the report issued within the requested turnaround time? ❑Yes❑No If no,what was the turnaround time? Annroved by Stgnature -__ ______- -Company �_---_ �-----_ -- — Date, ___