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❑680 Chesapeake Drive•Redwood City,CA 94063•(650)3640 ❑18939 120th Ave,N E Suite 101 a Bothell,WA 98011 •(206)4 10—00 <br /> UN�AL ❑819 Striker Ave.Sulte 8•Sacramento,CA 95834•(916)921-9600 El East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> ❑404 N Wiget Lane•Walnut Creek,CA 94598•(925)988-9600 ❑15055 S W Sequoia Pkwy,Suite 110 a Portland,OR 97222•(503)624-9800 <br /> O 1455 McDowell Blvd North,Suite D•Petaluma,CA 94954•(707)792-1865 <br /> Consultant Company C 0%4w- um fns, Z1W X 90 a s�1. d►' Project Name r-j)r t"w <br /> Address• G:7 v4 S r f rrQ e e.,.� � S.��f UNOCAL Project Manager t j,, �a�/ Q �► " <br /> City Orsi 4 a State Co . Zip Code 9Vs6$ AFB # <br /> _ Telephtine(gZ FAX T23)s�r Site #, City, State 14,6 r t?n c.t +`c A <br /> Report To.JeQ.+.+�w . ��rcLcrs Sampler t/asr •s S I��I a► ° QC Data Level D (Standard) ❑ Level C ❑ Level B ❑ Level A v <br /> Turnaround ❑10 Work Days $5 Work Days ❑3 Work Days ❑ Drinking Water rAnalyses Requested ti <br /> Time- ❑ 2 Work Days 01 Work Day ❑2-8 Hours ) Waste Water <br /> CODE: ❑Misc ❑Detect ❑Eval ❑Remed ❑Demol ❑Closure ❑Other <br /> Client Date/Time Matrix # of Cont Laboratory 6Comments <br /> t ;Sample I D Sampled Desc Cont Type Sample # <br /> 'Ta:Lr4 W r VO4 <br /> 2. 3 X <br /> 4. :3 r.s4i 4 3 4 <br /> 5. 1):6.r^ it J 0- <br /> 6 '3 V^ 4 3 4 x <br /> 7." 1. ;ipM 3 of <br /> 9:• 1r/•� :!3 k n <br /> ;St fAt <br /> r <br /> Relinquished By Data 1< Received B Time p y _ <br /> SO to S L Ti'me a� <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Lab Date Time <br /> Were Samples Received in Good Condition? ❑Yes ❑No Samples on Ice? ❑Yes ❑No Method of Shipment Page_of <br /> To be completed upon receipt of report <br /> .1)Were the analyses El <br /> no, what <br /> s are <br /> 4R. f 2)Was the report Issued within t he requested turnaround time?ot)the Chain of Custody ed�El Yes <br /> No No If not what was the turnaround <br /> It time? <br /> Approved by Signature Company Date <br />