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680 Chesapeake Drive•Redwood City,CA 9IF'(9116) <br /> (415)364-9600 U 19939 120th Ave,N E,Suite 101 •Bothell,WA 98011 •(206)481-9200 <br /> FJ 819 Striker Ave,Suite 8•Sacramento,CA 95 921 9600 U East 11115 Montgomery,Suite B•Spokane,WA 99206 40 924-9200 <br /> U N O C Q- r U 404 N Wi et Lane•Walnut Creek,CA 94598. 510 988-9600 U 15055 S W Sequoia <br /> g ( ) q Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Consultant Company Project Name - �/ I <br /> C ei — ct•'� ) rod cr motor-i LZf <br /> Address ci`j ,1e11'c .��� 1 C) 62,02 UNOCAL Project Manager f <br /> City u ,, l2A- State Zip Code JqS4,Y AFE# <br /> c <br /> a� <br /> Telephone LO ` I-- SSS FAX <br /> 7# S�llo ! S&-7ft Site #, City, State L121 S '0L1C . v <br /> Report To� �] r1C1 Sam ler ` l�c 6u 1,gA7 i kLx,, QC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A S <br /> Turnaround 10 Work Days ❑ 5 Work DaYs ❑ 3 Work DaYs Analses Requested c a. <br /> ❑ Drinking Water t A7 <br /> Time ❑ 2 Work Das 06 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 I D Sampled Desc Cont Type Sample# �C �j Comments <br /> ZN <br /> 01 <br /> co <br /> 'a <br /> --2 Z Z- 16'ao a ns <br /> ,3 3 <br /> `w <br /> ,. `fid �S rb >- <br /> 6 -5 — ' 2 Db w na4 <br /> •!S 01 <br /> 8 <br /> 9 <br /> 10 R <br /> 17 0 <br /> Relinquished By Date Y —1� Time 7!ov Received By LA) Date -- c Time <br /> m <br /> L <br /> Relinquished By Date Time p Received B tf Date �1 Time D 61118t <br /> �-� Date ///� c `) �b i l5 <br /> Rehn wished B Time 9/� Received B Lab M.� Date Time <br /> e Samples Received in Good Condition?❑Yes U No Samples on lce? Cl Yes 0 No Method of Shipment Page_of <br /> r� <br /> ti pleted upon receipt of report <br /> e analyses requested on the Chain of Custody reported? ❑Yes O No If no, what analyses are still needed? <br /> ort issued within the requested turnaround time? u Yes Q No If no, what was the turnaround time? <br /> Signature Company Date <br />