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t J I <br /> L Ll 680 Chesapeake Dnve•Redwood City,CA 1 <br /> 94063�1(654)354-9600 018939 120th Ave,N E Suite 101•Bothell,WA 98011 •(246)481-9200 <br /> UUOCALL)819 Striker Ave,Suite 8•Sacrament%` CA 9583411(916)921-9600 ❑East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9240 <br /> ❑404 N Wiget Lane•Walnut Creek,CA 94598•(925)98&9600 ❑15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> 1 11 it <br /> U 1455 McDowell Blvd North,Suite D•Petaluma,CA 94954•(707)792-1865 <br /> 1 11Consultant Companya$7f I'$rte Protect Namer��,- <br /> Address b}'�f ,Si..�'� Caw -�'�.•.^tom S iE UNOCAL Project Manager fir• JVfG�G N`, <br /> City Z)C, State (Z, Zptode 9-V"5—rz8 AFE,# <br /> City, State / m <br /> Telephon9lA) Sal �- .!'"S7 FAX# 7r).S'.'�1.. 1� Site#, � � t. UP <br /> Report To JJ �f Q,.�l y Sampler ow`fid.3 �-L4,IQ� OC Data Level D (Standard) ❑ Level C U Level B ©Level A Y <br /> Apoy <br /> Tumaround �10 Work Days ❑5 Work Days ❑3 Work Days ❑Drinking Water Analyses Requested a. <br /> Time: 0 2 Work Days ❑ 1 Work Day ❑2-8 Mours � )Waste Water <br /> u T"_ <br /> CODE: ❑Misc ❑Detect III Eval ❑Homed ❑Demol ❑ClosureI i ❑Other 1 <br /> ,f �0 �a'� <br /> R Client Date/Time Matrix # of Cont Laboratory �y ,� Comments <br /> SaAple I D Sampled Desc Cont ,;Type; I'Sample# - <br /> pp � <br /> l#tc� �°Ali h se ° <br /> # - tel. 1 0� ,3 , o <br /> 2 MW.r 1 n <br /> 3 AW ' ! 1' — X r s 3 <br /> � - : N X <br /> 5 M,�.�F r a� 44Lii <br /> -X-1-1 <br /> B HW. .� jl� ••. l "- i1 <br /> < K X X z <br /> s M -g <� ti r Y 1� 1 - x o <br /> 10 MGf-`fi �. 5i �E �� •1C X <br /> Date I3 II Time �' Received By Dateu, Tlmej .`tiff m <br /> Relinquished By f L10 t <br /> Relinquished By Date, �t a Time Recelved By Date Time ��v <br /> li t� <br /> Relinquished By Date 1 Date <br /> az <br /> Tme. Received By Lab 4 Tlme <br /> Were Samples Received in Good dibon? ElYes ❑No I, iSam ples on Ice? ❑Yes ❑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 repotted? O Yes ❑ No If no, what analyses are still needed? <br /> 2)W report Issued within the requested turnaround time?11 QI Yes No If no, what was the turnaround time? <br /> ApprovedRIF l �� ►? Signature mpany <br /> G —,2 � D V <br />