Laserfiche WebLink
-,__ ____ — I4JJJ ILVuI^VU.IVL,OLMU IUI •00 <br /> ll1011, VVA tRS*LUo)4111 JGUU <br /> U W C n L U 819 Striker Ave,Sudo 8•Sacramento,CA04•(916)921-9600 0 East 11115 Montgomery,Sulta B•Spokane WA 99 509)924 9200 <br /> V A U 404 N Wiget Lane•Wainul Creek,CA 94598•(51o)988 9600 U 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624 9800 <br /> Consultant Company ` vc- 0--%J W CP,f protect Name O <br /> Address H <br /> UNOCAL Protect ManagerCity /fO <br /> � C�c ;V.0C <br /> AFE # <br /> TelephoneE �( FAX # Site#, City, State <br /> U <br /> Report To Sam !er Data ❑ Level D(Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaroundork Days ❑ 5 Work Days ❑ 3 Work Das <br /> y ❑ Drinking Water Anal ses Requested <br /> Time ❑ 2 Work Das ❑ 1 Work Day,,, ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Mlsc ❑ Detect ❑ Eval AFfemed ❑ Demol ❑ Closuret er <br /> Client DatelTlme Matrix it of Cant Laboratory <br /> Sample I D Sampled Desc Cont Type Sample it Comments <br /> 0 <br /> 2 <br /> 0 <br /> 3 <br /> J <br /> 4 <br /> 5 <br /> m <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> 0 <br /> r n <br /> 0 <br /> Rehn uished B + <br /> 4 y Date Time (�} Q Received By <br /> Date Time -i <br /> Relinquished By bate Time Received B <br /> Date Time <br /> Relinquished By I Date Time Received By Lab <br /> Date Time <br /> Were Samples Received in Good Condition?a Yes U No Samples on Ice? U Yes Ct 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❑ No If no,what analyses are still needed? <br /> 2) Was the report Issued within the requested turnaround time? ❑Yes O No If no, what was the turnaround time? _ <br /> Approved by _—_ Signature _ — _ an Com <br /> p Y ----- ----- —- - - --Date <br />