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U 680 Chesapeake Drive•Redwood City CA 94063•(650)364 9600 • U 18939 1201h Ave,N E Suite 101 •Bothell,WA 98011 •(206)481-920 <br /> UNOCAIL]919 Striker Ave Suite 8•Sacramento,CA 95834•(916)921-9600 U East 11115 Montgomery Suite B•Spokane WA 99206•(509)924-9200 <br /> U 404 N Wiget Lane•Walnut Creek,CA 94598•(925)988 9600 L7 15055 S W Sequoia Pkwy Suite 110•Portland,OR 97222*(503)624-9800 <br /> U 1455 McDowell Blvd North Suite D•Petaluma CA 94954•(707)792-1865 <br /> Consultant Company ,� _ -� Project Name /L, 57— ��, Ac::__ <br /> Address 4-1— s", f C " UNOCAL Project Manager S <br /> StateLIA- Zip Code try�, AFE # <br /> Telephone _� 7 S y� FAX # r�2 Site #, City, State <br /> Report To S J24 <br /> (, �-Tz,_, Sampler OC Data ' vel D (Standard) 0 Level C O Level B ❑ Level A <br /> x <br /> Analyses Requested <br /> Turnaround �Work Days ❑5 Work Days 0 3 Work Days ©Drinking Water Yo_ <br /> Time- 2 Work Days ❑ 1 Work Day ❑2-8 Hours ❑ Ste Water <br /> CODE: O Mlsc LDe1 t Eval ElRemed ❑Demol C3Closure ther <br /> Client Dae Ime Matrix # of Cont Laboratory �k Q jComments <br /> Sample I D Sampled Desc Cont Type Sample # V ,/ <br /> ��.-Z 12 f(S G� . f �� ; 0 - �. <br /> 1 O <br /> E <br /> 2 - Q �y 7Y <br /> G 7 ,00 <br /> 3 Z 3 <br /> aI ito <br /> Hew) <br /> 6 <br /> 7 <br /> 8 0 <br /> 9 V <br /> a <br /> 10 CIS <br /> J <br /> Relinquished By -t - Date : li Time Received By ` Date/. �'' Time /170 <br /> s <br /> Relinquished By Date G XZ-v I Time lf7l- - Received By Date Time <br /> Relinquished By Date Time Received By Lab Date4 Time �S S <br /> Were Samples Received in Good Condition? ❑Yes O No Samples on Ice? ElYes ❑No Method of Shipment Page , of _ <br /> To be completed upon receipt of report <br /> 1)Were the analyses requested on the Chain of Custody reported9 ❑Yes U No If no, what analyses are still needed? <br /> 2)Was the report issued within the requested turnaround lime? U Yes ❑ No If no, what was the turnaround time? <br /> CIr+nafllrP <br /> C'mmpanv Date <br />