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❑ 680 Chesapeake Dnve•Redwood City,CA 940' 15)364-9600 ❑ 18939120th Ave,N E.Suite 101 •Bothell,WA 98011 •( 1-9200 <br /> U (t'AL ,9 ❑ 819 Striker Ave,Suite 8•Sacramento,CA 95834 16)921-9600 Q East i 1115 Montgomery,Suite B•Spokane,WA 99206•(50 924-9200 <br /> ❑ 404 N Wiget Lane•Walnut Creek,CA 94598•(510)988-9600 Q 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Consultant Company "iProfect Name <br /> , <br /> Address q% f61yr <br /> '7 r - .y <br /> 0UNOCAL Project Manager rLL /S�vs , <br /> City r;,E State �',n? Zip Code f AFE# <br /> TelephoneG c)' --41411 - 7 �-DC FAX# Site #, City, State U <br /> Re ortTo /, ,r�q �� �,h Sampler '', ,,' Ltd c C. h�j QC Data � evef D(Standard) ❑ Level C ❑ Level B ❑ Level A c <br /> Turnaround;Ef-tl] Work Days ❑'5 Work Days ❑ 3 Work Days ❑ Drinking Water Analses Requested IL <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc ❑ Detect ❑ Eval 'Ptemed ❑ Demol ❑ Closure A Other��' <br /> Client Date/Time Matrix #of Cont Laboratory <br /> Sample I D Sampled Desc Coat Type Sample# ��� Comments ' <br /> }� r <br /> Lo <br /> 3 c13 <br /> 4 <br /> 0 <br /> 5 w <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 o <br /> _ J <br /> Relinquished By ;�'� 71 co <br /> Date /C�_r: t, Time 14 Received B Date Time J <br /> Relinquished B � <br /> q y Date Time Received By Date Time <br /> Relinquished By- Date Time Received By Lab I Date iTime + <br /> Were Samples Received in Good Condition?❑Yes❑ No Samples on Ice? ❑Yes❑No Method of Shipment Page_of 1 <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑ Yes❑No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes C)No If no, what was the turnaround time? <br /> Approved by ----------Signature _ Company Date <br />