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I -' ��u.I ��-\� � Jlllll 4V 1 uU11141i, YYI\ JVV 4 1 �� 1 JG VU <br /> U N A L U 1119 Sinker Ave,, Sudo 8•S7c ramenlo CA 958 9[6) 421 9GUo U l ast 1 1 115 Monlgoriery Suite B•Spokane WA 99206. 5 24 9200 <br /> U 1900 Bates Ave,Suite LM•Concord CA 94520•(510)686 9600 U 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624 9600 <br /> Company Name \ \! ' <br /> } r l ��r n 3t1t,1 { tri Protect Narne - l:�; }, 1(�h� ,�r�(Y "(Y ( 1 �/ <br /> Address ,,4>4 L r rl r <br /> 12 <br /> 1 <br /> ' UNOCAL Project Manager <br /> City A? � f vi L State A rZip Code r I� � Release 11 <br /> ! r <br /> Telephone j f�J(' 1 FAX# 'f J' - ` 'r <br /> . / )� , Site It <br /> // + U <br /> Report Td' )( -K.`(V t , Sam eler ' }f 1 ) ����-��}��-; OC Data 21 Level D (Standard) ❑ Level C ❑ Level B ❑ Level eves A 9 <br /> 5 Work Days ❑ 3 Work Days ❑ Drinking Water Analyses Re uested IL <br /> Time ❑ 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours <br /> ❑ Waste Water <br /> CODE ❑ Misc ❑ Detect ❑ Eval 2 Remed ❑ Demol ❑ Closure ❑ Other )d <br /> Client Datef-rime Matrix of Cont \ <br /> Laboratory <br /> Sample 1 D Sampled Desc Cont Type Sample 1f r V\ Comments <br /> f� O <br /> 2 r <br /> 3 n° <br /> c� <br /> 4 ,i <br /> 3 <br /> 5 0 <br /> a� <br /> 7 <br /> B <br /> 9 <br /> 10EEI F <br /> I � <br /> ro <br /> Relinquished By }l,I ;1 Date (,i,Y' ( Time+ ' Received B Date <br /> Relinquished By Time <br /> `n <br /> ( 1 Date Time Received E3 <br /> Date Time <br /> Relinquished B _ 1 <br /> Date Time I neceived By Lab Date <br /> Tune <br /> Were Samples Received In Good Condition 2 U Yes IJ No Samples on Ice? U Yes U No Method of Shipment <br /> Page�of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? U Yes IJ No If no, what analyses are stili needed9 <br /> 2) Was the report issued within the rer)uested lurnaround time? U Yes U No if no, what was the turnaround tune? <br /> Annrnlrpri by C, , ,-.r <br />