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Y <br /> U 819 Sinker`Ave,Suite 8•Sacramento CA 958316)921 9600 U East 11115 Montgomery Suite B•Spokane,WA 99206• 249200 <br />` U" A^ f U 404 N Wiget Lane•Walnut Greek,CA 94598•(510)988 9600 U 15055 S W Sequoia Pkwy,Suite 110•Portland OR 97222•(503)624 9800 <br /> I <br />� Consultant Company 1,r t t f l( � �.t t { <br /> Project Name <br /> Address <br /> s , - r' UNOCAL Project Manager 11 i 0 <br /> - + ` � � � ,� +r s 1 � <br /> City _ ,i ' State Zip Code ; ' I t , AFE #f <br /> Telephone a i - FAX It `r �, A Site It, City, State <br /> Report To �+ j! ' f ' l 1' S Z Sam lerl OC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A C <br /> � I <br /> Turnaround ❑ 10 Work Days Q 5 Work Days U 3 Work Days IJ Drinking Water JAnalyses Re uested <br /> Time I] 2 Work Das I] 1 Work Day IJ 2-8 Hours IJ Waste Water <br /> CODE IJ Misc 13 Detect G Eval 0 Remed IJ Demol IJ Closure ❑ Other,}`_i + Rti <br /> Client Date/Time Matrix it of Cant Laboratory � <br /> Sample I D Sampled Desc Cont Tyne Sample#k �, ` Comments <br /> 0 <br /> 2 <br /> 3 ' <br /> 3 <br /> 0 <br /> 4 <br /> � I <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 1e ° <br /> 0 <br /> Relinquished By ' t , Date Time Received By Date__ - - — Time <br /> Relinquished By Date Time Received By <br /> _ Date Time <br /> ' / <br /> Relinquished B Date Time Received B Lab - 1 Date S �� Time <br /> Were Samples Received in Good Condition?U Yes L)No Samples on Ice? U Yes U 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? U Yes IJ No if no, what analyses are still needed? <br /> 2) Was the report issued within the requested Iurnaround lime? IJ Yes IJ No If no, what was the turnaround time? <br /> Annrovarf by Signature Company _ Date <br />