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680 Chesapeake Drive•Redwood City,CA 94015)364-9600 ❑ 18939 120th Ave,N E,Suite 101 •Bothell,WA 98011 •(`� 1-9200 <br /> C)U A L 819 Striker Ave,Suite 8.Sacramento,CA 9583It 6)921-9600 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99206•( 24-9200 <br /> ❑ 404 N Wget Lane•Walnut Creek,CA 94598•(510)988 9600 O 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Consultant Company �Ac(— ProfectName SL[ Z ( <br /> Address 6`79 7lcC'-f- UNOCAL Project Manager <br /> City b (,4 State Zip Code AFE# <br /> a <br /> Telephone FAX# S Site#, City, State 2,1 Sts c O ,-, tj <br /> Report To Goa am ler /tJ �� rit rn� ) Y <br /> L 1 of 1 QC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A C_ <br /> 10WorkDaYs ❑ 5WorkDaYs ❑ 3 Work Days aTurnaround Drinking Water 4 Analses Re uested <br /> Time. ❑ 2 Work Das 0 1 Work Da ❑ 2-8 Hours ❑ Waste Water �c r <br /> CODE: 1:1Misc Detect ❑ Eval ❑ Remed ❑ Demol C) Closure ❑ Other 17 ? <br /> G <br /> Client Date/Time Matrix #of Cont Laboratory ofl��C <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> 1 4 rZ —25 z' e ( I ��1�� E-� T 7� <br /> 2 co <br /> 3 l 0 <br /> O <br /> 3 ca <br /> 4 <br /> C D!cl C'ai",0ay t oS <br /> 5 f Ynm <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> o I <br /> CIS <br /> 7 0 <br /> M <br /> Relinquished By L Date l6 cy Time �' Received By <br /> Date q-[ -'� Time lP <br /> m <br /> Relinquished Byt1�16Dater-1-.,9Time ReceiveojE Date Tlme <br /> i -- <br /> Relin uishe Date Time Received By Lab Date 7 Time l <br /> Were Samples Received in Good Condition?❑Yes❑No Samples on Ice? ❑Yes O No Method of Shipment Page of <br /> I <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes❑ No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? U Yes❑ No If no, what was the turnaround time? <br /> oproved by Signature Company Date <br />