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U <br /> �� �L U 680 Chesapeake Drive•Redwood City,CA 94063•(650)3r 0 U 18939 120th Ave,N E Suite 101 •Bothell,WA 96011 •(206) 200 <br /> ❑819 Striker Ave,Suite 8•Sacramento,CA 95834-(916)92 ❑East 11115 Montgomery,Suite B-Spokane,WA 99206•(50 -9200 <br /> ❑404 N Wiget Lane•Walnut Creek,CA 94598•(925)988-9600 ❑15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> ❑1455 McDowell Blvd North,Suite D•Petaluma,CA 94954•(707)792-1865 <br /> Consultant Company � f _ Z$dv Protect Namee.r' eo ' Z 8 <br /> Address c� S'�CT�'bl (;air 'tc J UNOCAL Protect Manager M �f <br /> City Kb State Zip Code g AFE # Il 1 <br /> Telephon T � )— �-rTS FAX # `�L S'Ys 7$� Site#, City, State!66 f- rte „ C' _ m <br /> Report To Sampler V1M2*-w raA /Q-o OC Data Level D (Standard) 0 Level C O Level B ❑ Level A v <br /> X <br /> Turnaround10 Work Days ❑5 Work Days ❑3 Work Days 0 Drinking Water Analyses Requested ti <br /> Time: 2 Work Days O i Work Day ❑2-8 Hours Waste Water `C► C <br /> CODE: 0 Misc 0 Detect C3 Eval Remed 0 Demol ❑Closure 0 Other y�b `< <br /> Client Date/Time Matrix #of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample # Q ,� Comments <br /> a <br /> ` L <br /> 1 N- 1602 <br /> ca <br /> 3 - o �r 03 <br /> 4 t4 I,c1'-3 - h Y, g umffi-s- tnbAo <br /> m <br /> S S ti ti 0� <br /> 07 <br /> aAuf— o: &zA- <br /> 9 NtJ- v• c aP 4 0� z <br /> 0 <br /> 10 N&r `T yl �1P �' I0 �° <br /> CSS <br /> J <br /> Relinquished By Date Time ,�O Received By Date Time <br /> r <br /> Relinquished By C Date I Time Received By -Z Time 3 <br /> Relinquished By Date Time Received By Lab s Date /I f Time (6 'A <br /> Were Samples Received in Good Condition? 0 Yes 0 No Samples on Ice? 0 Yes ❑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 0 No If no, what analyses are still needed? <br /> 2)Was the report issued within the requested turnaround time? ❑Yes 0 No If no, what was the turnaround time? <br /> Approved by Signature Company Date <br />