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- t <br /> ��®CAL Q�°Chesapeake Drive•Redwood City,CA 34083•(650)364 9fi00 0 18939 120th Ave, N E Suite 101 •Bothell,WA 98011.I •(206)481 9200 <br /> 819 Striker Ave.Suite 8•Sacramento,CA 95834•(916)921-9600 ❑East 11115 Montgomery,Suite B•Spokane,WA 99208•(509)924-9200 <br /> t! 14 j+ O 404 N Wiget Lane•Watnut Creek,CA 94598•(925)988 9600 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)824-9800 <br /> Q� r ❑1455[McDowell Blvd North,Suite D•Petaluma,CA 94954•(707)792-1865 <br /> Cortsul'tant Company aL,+ Jre. AJ.* Zia a XV. F i— Project Name <br /> Add %;W7'Cx77-P S/orr<a fou/ x.`74 c7, UNOCAL Project Manager 14r . R&J Ro s� ; <br /> City- State C% zip Code pa/_rC $ AFE #JL. ;I <br /> YLJ <br /> Telephon qz r) _nn— :7 r r/ FAX # it r).r /. Site #, City, State /1.6 S" c w1k / •i S'l�ac/�„ r , CA <br /> Report To,��Q �• yb�q�,� Sampler ��-A •'B OC Data (j Level D (Standard) ❑ Level C 13 Level B1 El Level A v <br /> 1Lma'round C310 Work Days 5 Work Days ❑3 Work Days 0 Drinking Water Analyses Requested a. <br /> Time:-s} 0 2 Work Days Cl 1 Work Day ❑2-8 Hours A Waste Water <br /> CODE:a 0 Misc 13 Detect ❑Eval O Remed ❑Demol ❑Closure O Other <br /> : 't.Chent D lme Matrix # of Cont Laboratory <br /> -�,, i �� �' , � �I Comments <br /> , ej Sample I D TampTed Desc Cant Type Sample # Q <br /> ;1. <br /> 4f I a soy 1,.! 3 vJy4 <br /> 2 1 /6;3, ti 3 ii <br /> 3' <br /> 4.' *�'`F <br /> 5 14 <br /> it J <br /> f , - Times <br /> jHelinquished By Date Sh Time���{� Received By r Date "� � � r C� <br /> '�. I <br /> [�Relinqufshed By Date Time Received By Date Time <br /> tt� 1 !' <br /> zt Relinquished By Date Time Received By Lab Date Time <br /> • o4if t;idt: <br /> Were Samples Received in Good Condition? ❑Yes 0 No Samples on Ice? ❑Yes 0 No Method of Shipment Page_of <br /> To be�completed upon receipt of report 1� <br /> h1)1Nere the analyses requested on the Chain of Custody reported? D Yes ❑ No If no, what analyses are still needed <br /> 1 2)`Was'ihe report issued within the requested turnaround time? ❑Yes ❑ No If no, what was the turnaround time9 <br /> l Approved 1 Signature Company J Da <br />