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0 0680 Chesapeake Drive•Redwood City,CA 94063•(650)364-9600 0 18939120th Ave,N E Sulte 101 •Bothell WA 98011 •(206)481-92 <br /> UNOCAL ❑819 Striker Ave.Suite 8•Sacramento,CA 95834•(916)921-9600 O East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> 13 404 N Wiget Lane•Walnut Creek,CA 94598•(925)986-9600 0 15055 S W Sequoia Pkwy Suite 110•Portland OR 97222•(503)624-9800 <br /> O 1455 McDowell Blvd North,Suite D•Petaluma,CA 94954•(707)792-1865 <br /> Consultant Company (�' erg IE ods Yn�- , , �-�`�d Protect Name r-OrO'71-r- Z <br /> Addrdss X..4-4- �r UNOCAL Project Manager <br /> City, b LX State Zip Code Ty y%S AFE # <br /> Telephone FAX # Lr) C- �79'9'8 Site #, City, State 1,c <br /> Report To(� Sampler � � ^ QC Data level D (Standard) ❑ Level C ❑ Level B ❑ Level A U <br /> 0 Work Days 5 Work Days ❑3 Work Days 0 Drinking Water Analyses Requested <br /> Turnaround AJ <br /> d <br /> Time: ❑ 2 Work Days ❑1 Work Day O 2-8 flours 9"'Waste Water <br /> CODE: ❑Misc O Detect ❑Eval 0 Remed 0 Demol 0 Closure 0 Other <br /> Client Date/Time Matrix # of Cont Laboratory Comments AI <br /> Sample I D Sampled Desc Cont Type Sample # <br /> 3 Vo <br /> L <br /> Q <br /> 2 4 V Z <br /> 3 uw� 3 3 �- D J <br /> 5 MI/i rr 'OG 3 w (r7�t., rn `�r►� ��laTiK- } <br /> f 7 Mrs- 11 .'to DC� x <br /> 8 µ(J 8 3 ti 0 <br /> 9. W t !6' 3 !b <br /> EL- <br /> 10 Rix.,C D 6 <br /> Relinquished ByDate ;/ Time 2v' 0 Received By. Date G p j Time L6 �d m <br /> r <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By t Date Time Received By Lab Date Time: <br /> Were Samples Received In Good Condition? ❑Yes ❑No Samples on Ice? 0 Yes ❑No Method of Shipment Page,__of <br /> TbeTocompleted upon receipt of report <br /> )Were the analyses requested on the Chain of Custody reported? O Yes ElNo It no, what analyses are still needed)) Was the report issued within the requested turnaround time? ❑Yes Q❑ No If no, what was the turnaround time? <br /> _ <br /> 4 , <br /> � h 0 #n 1,. Glnngtl PrP PA �-1� mmnanv ����C.� • Dats: L2 V <br />