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JUN0(*L ❑680 Chesapeake Drive•Redwood City,CA 94063•(650)364-9600 U 18939 120thAve,NE Suite 101 •Bothell,WA98011 ,eUB 481-91Uu ❑819 Striker Ave,Suite 8•Sacramento,CA 95834•(916)921-9 ©East 11115 Montgomery,Suite B•Spokane,WA 99206•(509) 00 ❑404 N Wiget Lane•Walnut Creek,CA 94598•(925)986-9600 ❑15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503 24-9800 13 1455 McDowell Blvd North,Suite D•Petaluma,CA 94954•(707)792-1865 Consultant Company j�,�yQ,. ,�nG, .11�y Z$ct)Sy.g'g— Protect Name r rrn Y- JA J il Z 3LS-F Address S i g-/l'-Q Cu cvr7' UNOCAL Protect Manager Nr. S 0 6 4 6 cW-9,1" City cL�14 J State C,ck . Zip Code Clgj-4 g AFE # 3 Telephone('77 �.fl•-�sS� FAX Q1 r SS 1.��y Site #, City, State /( ,,� ,` 4 n C.s� . CD Report To•� � G � ,� Sampler `j (Standard) U P s QC Data Level D Standard ❑ Level C ❑ Level B Level A , x Analses Re uested Turnaround �10 Work Days ❑5 Work Days E)3 Work Days ❑Drinking Water Y q Q. ACV 6.10 Time- 2 Work Days ❑ 1 Work Day ❑2-8 Hours rh Waste Water p CODE: ❑Mise ❑Detect ❑ Eval #Remed ❑Demol ©Closure ❑Other Client DateMme Matrix # of Cont Laboratory �4 \, Comments Sample I D Sampled Desc Cant Type Sample # 2 I s 1•t c -a l Z-Ft–G l� l� 7� C ^ L 3 4 a } 5 6 7 1 8 21 9 ° �n L 10 0 J Relinquished By ate Time z� Received By - « Date Time (C1 20 iiiZ Relinquished By Date Time Received By Date Time Relinquished By Date Time Received By Lab w�J Date �'�� Time Were Samples Received in Good Condition? ❑Yes ❑No Samples on Ice? ❑Yes O No Method of Shipment Page—of To be completed upon receipt of report 1)Were the analyses requested on the Chain of Custody reported? ❑Yes ❑ No If no, what analyses are still needed? 2)Was the report issued within the requested turnaround time? ❑Yes ❑ No If no, what was the turnaround time? Approved by Signature Company Date