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O 680 Chesapeake Drive•Redwood City,CA 94063•(415)364 9600 U 18939 12001 Ave,N E,Suite 101 •Bothell.WA 99011 •(206)481 9200 s <br /> un�oL <br /> O 819 Striker Ave.Ave,Suite 8•Sacramento,CA 95834•(9 1 9600 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99206•(50 9200 <br /> O 404 N Wi el Lane•Walnut Creek,CA 94598•(510)988-9600 O 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503J'S24 8800 <br /> Wig <br /> el <br /> G� - s Protect Name � a-,r 0Assc 5C, 4 535 <br /> Address' `+ q .54-e �' UNOCAL Protect Manager (VAT. Bn 6rt <br /> City V n State Cjff Zip Code 9 yi�-6 AFE # <br /> c <br /> m <br /> Tele honFAX# as)9-91— -+�i III Site #, City, State k4-6,1C U <br /> L ISampler ✓ � 7 ► DC DataLevel D (StandRe ortTo &,%,,, ard) ❑ Level C ❑ Level B ❑ Level A - <br /> Turnaround 10 Work Das ❑ 5 Work Das ❑ 3 Work Das <br /> Y Y Y ❑ Drinking Water Anal ses Re uested 9P/� 31 <br /> Time: ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours Waste Water <br /> CODE: ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other / } <br /> ' Client Date/Time Matrix #of Cont Laboratory � <br /> Sample t D Sampled Desc Coni Type Sample# Q Comments <br /> 1 rB_c s V Z> 1 ✓�,4 x <br /> co <br /> 4 w. 3 ✓ 15opoy �. 4 o <br /> Z��; `r�C' SNA r <br /> 7 W. b ✓ SI:a t w ,� f X X V <br /> 9 NkI ✓ /L: Y S 4 �C <br /> 10 Mtn' <br /> 0 <br /> Relinquished By Date tZ T1me 0:SV eceived B Date e----- <br /> Q) <br /> I <br /> Relinquished By Date Time Received By Date Time <br /> Rehn(jwished By <br /> Date Time Received B Lab Date)ZI�I Time fk c7 <br /> Were Samples Received in Good Condition?Pes❑No Samples on Ice? )kYes U 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? 0 Yes Cl No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes❑No If no, what was the turnaround time? <br /> A--—A r,., Cannatllrp rnrnnanv __ Date � <br />