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011 0 0 <br /> ❑ 684 Chesapeake Dnve•Redwood City CA 94053•(415)354-9600 Q 18939 1201h Ave,N E,Surae 10i•Bothell,WA 98011 •(206)481 9200 <br /> in �� I 0 819 StrlkerAve Suite 8•Sacramento,CA 958.34•(916}921-9600 U East 11115 Montgomery,Suite H•Spokane WA 99206•(549)924-9200 <br /> U-1) Q 404 N Wiget Lane•Walnut Creek CA 94598•(510)9138 9600 U 15055 S W Sequoia Pkwy,Suite 110•Porliand OR 97222•{543}824 9800 <br /> N <br /> m Consultant CompanyCR C cza� Project Name 't'ZS <br /> M 6 <br /> Addressit <br /> eD 2S q 1%C_,o F UNOCAL Project Manager s -- <br /> a City �Q, State t� Zip Code AFE# p <br /> C <br /> m Telephone f-~7 500 FAX# 7-441—7 , M Site#, City,State ct d C-m4 t] <br /> Report To ,oytcQ4 6e Sam ler DC Data evel D standar ❑ Level C ❑ Level B ❑ Leve! A c <br /> � <br /> Turnaround Work Das 5 Work Da S ❑ 3 Work DaY Y Ys C1 Dunking Water Analyses Requested <br /> Time: ❑ 2 Work Das ❑ I Work Da ❑2-8 Hours 1] Waste Water <br /> CODE: ❑ Misc ❑ Detect ❑ Eval �Aemed ❑ Demol ❑ Closure 11 -Other �• li <br /> Client Date/Time Matrix #of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample 0 Comments <br /> t r rG �i f 7�' I (� 0A o <br /> V- <br /> 2 q 12 0 <br /> Ln 3 <br /> J <br /> V 4 0 <br /> r 5 <br /> } <br /> 7 s <br /> Q 7 <br /> Q e <br /> tLan 9 <br /> i0 a <br /> m � <br /> m p <br /> N � <br /> Relinquished By r Date 6 Time Received B Date 6 Time /T/0 -' <br /> m <br /> m Relinquished By Dated TimeJ"¢r-r Received By Date Time <br /> Relinquished By Dale TimeReceived B L Date �1 'm'e <br /> Were Samples Received in Good Condition IYJ <br /> Yes Q No Samples on Ice? u Yes/! No Method of Shipment�� � ar�.f Page of <br /> To be comp Bled upon receipt of report <br /> iy Were the analyses requested an the Chain of Custody reported? Yes Q No If no, what analyses are still needed? <br /> 2) Was thW41�'con <br /> pod issued within the requested turnaround time? Yes ❑ No If no,what was the turnaround time? <br /> Approved by Signature _ _-- _ Company _[ � _ _Date T9[b �� <br />