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❑680 Chesapeake Drive•Redwood CiI CA 94063•(650)364-9604 O 18939 120th Ave,N E Suite 101 •Bothell,WA 98011 •(206)481-9200 <br /> UNOCAL ©819 Striker Ave,Suite 8•Sacramento,CA 95834•(916)921-9600 ' ©East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> O 404 N Wiget Lane•Walnut Creek,CA 94598•(925)988-9600 O 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> 01455 McDowell Blvd North,Suite D•Petalur ��GA 94954•(707)792-1865 <br /> it 1 <br /> Consultant Company �C cin .Thee Ta �Z$�Ot�. Project Name F),,M,,r & 1)a.0 St - Z g <br /> Address 6:F47- jQrM Cz"!t Se-e i G JIF UNOCAL Project Manager N►r• <br /> City p State Zip Code 9?,`,yS"6a AFE # <br /> Telephone ,rSy,_ ,S-rs-��` FAX #Qt ���� �$$$ Site #, City, State 22 <br /> 22 <br /> Report toe� Li Y r Sampler � � �I QC Data Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Y <br /> Turnaround10 Work Days 5 Work Days 613 Work Days ❑Drinking Water I Analyses Requested <br /> Time AO 2 Work Days O 1Work Day 0.2-8 HoursWaste Water <br /> ' 11 <br /> CODE: ❑Misc ❑ Detect ElEval O Remed ❑ Demo! 13IClosuii re O Other y <br /> Client Date/Time Matrix # of Corit Laboratory n Comments <br /> Sample I D Sampled Desc Cont Type IE Sample # <br /> � N � 1 + ��xo Z� s 'Uai4• �� 4�- �C X p <br /> 2 W r 1 Z, /6 zo <br /> 3 9,1 <br /> 4 MV,1 s -so <br /> 5 MV, 1 .5' clg <br /> s W_ 1 (0 iz; o <br /> 8 WrIo "J 1 l x <br /> 9 pod- o <br /> 10 N� �o r r :ra .,. , 3 hI �E a 1 X <br /> itIF A <br /> Relinquished By Date (, Time zQ,' Received By - Date (S Time ZO <br /> II t <br /> lt <br /> Relinquished By Date j+ Time Received By Date Time <br /> t <br /> Relinquished By. Date- ; Time. Received By Lab Date. Time. <br /> Were Samples Received in Good Condition? ❑Yes ❑No {h �6amples on lee? ID Yes O 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 rk port�e d? O Yes ❑ No If no, what analyses are still needed? <br /> 2)Wa a report issued within therenested turnaround time?J� a Yes No ! o, what was the turnaround time? FIIIIIIIIIIII <br /> Proved L Ignature pany C T D_ / <br />