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UN&A L fe ❑ 819 Striker Ave,Suite 8•Sacramento,CA 90(916)921-9600 ❑ East 11115 Montgomery,Suite So Spokane,WA 99206.024 9100 <br /> ❑ 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686 9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624 9800 <br /> Company Namel�` Vt Project NameFir <br /> Address e �51C, UNOCAL Project Manager <br /> City C State Zip Code Cnio Release# <br /> c <br /> a� <br /> Telephone FAX# Site# tj <br /> Report T Sam ler Dt QC Data bevel D(Standard) ❑ Level C ❑ Level B ❑ Level A e <br /> Turnaround i0 Work Days C) 5 Work Days ❑ 3 Work Days FJDrinking Water JAnalyses Re nested 4 Iq -72K- n- <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc ❑ Detect ❑ Eva) ;&'Remed ❑ Demol ❑ Closure W" Other <br /> Client Date/Time Matrix #of Coni Laboratory <br /> Sample I D Sampled Desc Cant Type Sample# Q� Comments <br /> Ar <br /> 2 ,�� f o <br /> 3 J <br /> 4 _o <br /> a� <br /> 5 } <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 g <br /> c� <br /> • o <br /> Relinquished By Time Received By Date Time <br /> a) <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By I Date ITime I Received BV Lab I Date j (9b�P Time 73C) <br /> Were Samples Received in Good Condition?O Yes❑No Samples on Ice? ❑Yes❑ No Meth o Shipment Page_of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody report d? ❑Yes❑ No If no,what analyses are still needed? <br /> 2) Was thepo iisssued within the requested turnaround time? Ye]�f�, If no,what was the turnaro tim <br /> Approved byres` Signature Company _ Date <br />