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• 0 680 Chesapeake Drive•Redwood City,CA 94063•(650)364-9600 O 18939 120th Ave,N E Suite 101 •Bothell WA 98011 •(206)4801-9200 <br /> UNOCAL 0 819 Striker Ave,Suite 8•Sacramento,CA 95834•(916)921-9600 Q East 11115 Montgomery, Suite B•Spokane,WA 99206•(509)924-9200 <br /> ©404 N Wiget 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 /> e IL <br /> Consultant Company Gr 7fii� �C lf>� ra 4P Z 9'00 >'-G Project Name Forme ✓ (Jyr I)e f Ss Z g <br /> Address 6;XJ47 S)OUI $ Cz s'ce G J� UNOCAL Project Manager Mr- 6"6 ye <br /> City I Z Statejrg • Zip Code AFE # <br /> Telephone SS/�_r- <br /> ;XX6 <br /> FAX #Q=��� �8$$ Srte #, Ctty, State <br /> U <br /> Report To eC�n L, >� r Sampler 'i QC Data Level D (Standard) ❑ Level C ❑ Level B ❑ Level A , <br /> Y <br /> Turnaround �10 Work Days 5 Work Days 0 3 Work Days ❑Drinking Water Analyses Requested ti <br /> Time: ❑ 2 Work Days ❑ 1 Work Day ❑2-8 Hours •,Waste Water <br /> CODE: O Misc 0 Detect 0 Eval ❑Remed E3Demol ❑Closure !❑Other ,y y <br /> Client DateMme Matnx # of Cont Laboratory a Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> 0 <br /> 2 MLAt I Z- <br /> 3 <br /> 3 13 'FS s <br /> 4. MV,I <br /> of- <br /> 6. <br /> 6. w_ I 1z"-!ea 4. <br /> 7 vA Lr- l ► ;3� ti ( X <br /> z <br /> 19 6z:its X tiC La <br /> io CD l <br /> Data Time ZQ; Received By Date f7 d Time, <br /> Relinquished By ' ` (o <br /> Relinquished By Date Time Received By Date Time, <br /> Relinquished By. Date Time Received By Lab DateTime: <br /> Were Samples Received In Good Condition? (3 Yes 0 No Samples on Ice? ❑Yes ❑No Method of Shipment Page <br /> To be completed upon receipt of report, <br /> 1)Were the analyses requested on the Chain of Custody reported? ❑Yes 0 No If no, what analyses are still needed? <br /> 2) Was the report issued within the Ze , <br /> sted turnaround time? ❑Yes ❑ o I o, what was the turnaround time? <br /> 07P.�SCinnati irP C pane 6:' Dant: _ _—_ <br />