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❑ 680 Chesapeake Drive•Redwood City,CA 94063. 415)364-9600 ❑ 18939 120th Ave,N E,Suite 3 of •Bothell,WA 98011 •(206 481-9200 <br /> (D v 819 Striker Ave,Suite 8•Sacramento,CA 9583 6)921-9600 ❑ East 11115 Montgomery,Suite Be Spokane,WA 99206•( 4-9210 <br /> UNCAL <br /> ❑ 404 N Wiget Lane•Walnut Creek,CA 94598•(510)988-9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Consultant Company eOle Project Name FM Ld, jC <br /> Address UNOCAL Project Manager N <br /> ak <br /> City la C <br /> State Zip Code 6j j& AFE# global If Q Q 70a 12-3 <br /> Telephone C°dIb 0e FAX# 7 Site#,City,State ;4314 hi(75 AreAref FAr <br /> Re ort ToCgl((V ALO Sam ler 6e <br /> fP QC Data 19 Level D( nd ) ❑ Level C ❑ Level B ❑ Level A E <br /> Turnaround 1010 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water ` [Analyses Requested a <br /> Time: ❑ 2 Work Das ❑ 1 Work DaX ❑ 2-8 Hour's ❑ Waste Water <br /> CODE: ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Date/Time Matrix #of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# Q� Comments <br /> 1 Wr /oarDa 6V 0 <br /> 2 .� <br /> 3 <br /> 4 <br /> 5 <br /> } <br /> 6 <br /> 7 <br /> 8 <br /> 10 0� <br /> 0 <br /> cd <br /> Relinquished By Date Time Received ate Time iroq3i <br /> 0 <br /> .� <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished B I Date ITime I Received By Lab I Date ITime <br /> Were Samples Received in Good Condition?0 Yes❑No Samples 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 reported? ❑Yes 0 No If no,what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes❑No If no,what was the turnaround time? <br /> Approved by Signature Company Date <br /> lr <br />