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U 680 Chesapeake Drive•Redwood City CA (415)364 9600 U 18939 1201h Ave N E Suite 101 •Bothell WA 98011 481 9200 _ <br /> � 19 Sinker Ave, Suite 8•Sacrarnenla CA <br /> UNOCAL X8 '9934 •(916)921 9600 11 bast 1 1 1 15 Mori) ami Suile 0•S ok ine WA 9 r < < 1V <br /> J Y 1 9206 {>o)) )I1 ) 1 ) <br /> U 1900 hales Ave Suite LM•Concord CA 94520•(15 10)686-9600 U 15055 S W Sequon Pkwy Suite 110•Portland OR 97222•(503)0,14 'M(K) <br /> Company Name <br /> ?I(,(.• v �,� { / Project Name < l <br /> Addless [ <br /> C' z C e xt @� D UNOCAL- Fligvcl Man,lg(,r lj yY, <br /> City eb'I _�u S P_ State 10-119 Zip Code U Release it <br /> Telephone ¢ - 7a FAX # p - --7,-r Site It S <br /> C7 <br /> Report To ��R e �K Sampler <br /> t, <br /> 11) QC Data vel D (Standard) IJ Level C IJ Level B LJ level A <br /> Turnaround Work Days [-'4)5 Work Days ❑ 3 Work Days IJ Drinking Water Anal ses Requested-1 <br /> Time ❑ 2 Work Das IJ 1 Work Da I"J 2-8 Hours IJ Waste Wal r <br /> CODE: IJ Mtsc IJ Detect IJ Eva) .11gaemed IJ Demol IJ Closure Other <br /> Client DatelTlme Matrix # of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample it Comments <br /> Lv C o <br /> 3 Q <br /> Wr <br /> 4 ' <br /> _o <br /> 5 �v <br /> 6 <br /> 7 <br /> B <br /> 9 <br /> 10 it <br /> 0 <br /> ff <br /> r � <br /> 0 <br /> Relinquished ByDate Time Received By Date Time -JRelinquished By Date Time Received By Date Time <br /> Relin uished8 Date Time ReceivedB Lab ti DbtL� Time l <br /> Were Samples Received in Good Condition?IJ Yes IJ No Samples on ice? IJ Yes IJ 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? "<Yes IJ No If no, what analyses are still needed? <br /> 2) Was the reporrrr�t`issued,wlthin the requested turnaround time? Yes IJ No If no, what was the turnaround lime? <br /> Approved by r <br /> Signature 1LJ Company PL Date <br />