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Ll 680 Chesapeake Drive•Redwood City,CA 0.(415)364 9600 Li 18939 120th Ave,rd E,Suite 101 •Bothell,WA 980116)4819200 <br /> UNSCAL U 819 Striker Ave, Suite 8•Sacramento,CA 95834•(916)921-9600 U East 11115 Montgomery, Suite B•Spokane,WA 99206•(509)924 9200 <br /> U 1900 Bales Ave,Suite LM•Concord,CA 94520•(510)686-9600 U 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624 9800 - <br /> Company Name Project Name <br /> Address UNOCAL_Protect Manager <br /> City State Zip Code r Release# L" <br /> t _ <br /> Telephone FAX# T <br /> r Site # T <br /> Re ort To U <br /> , <br /> Sam ler r r { QC Data ❑ Level D (Standard) ❑ Level C ❑ Level 6 ❑ Level A c <br /> Turnaround ❑ 10 Work Days ❑ 5 Work Days ❑ 3 Work Days <br /> Time1:1Drinking Water Anal ses Re nested <br /> ❑ 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours ❑ Waste Water <br /> CODE: E) Misc ❑ Detect ❑ Eval FJRemed ❑ Demol IJClosure 13Other il (' t <br /> Client Date/Time Matrix # of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample If ' <br /> t Comments <br /> 1 1 � i rwC <br /> 2 ° <br /> o <br /> cu <br /> 4 <br /> 5 3 <br /> _o <br /> a>' <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> ......... ..... 0 <br /> ro <br /> 0 <br /> Relinquished By ' Date#'� / Time � ,%{``' Received BDate TimeRelinquished ByDateTimeReceived B Date Time E <br /> Relin uished B DateTime Received By Lab L "4' S ) Date tf Time <br /> Were Samples Received in Good Condition?❑ Yes❑ No Samples on Ice? ❑Yes C) No Method of Shipment Pae TM of <br /> g <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? rJ Yes❑ No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? J Yes Q No If no, what was the turnaround time? <br /> Approved by Signatliro Company <br /> nate <br />