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680 Chesapeake Drive•Redwood City,CA 94063 )364-9600 0 18939 120th Ave,N E,Suite 101 •Bothell,WA 98011 •(206)481-9200 <br /> El 819 Striker Ave,Suite 8•Sacramento,CA 95834. 921-9600 ❑ East 11115 Montgomery,Suite B•Spokane WA 99206•(500 9200 <br /> U O A L 0 O 404 N Wiget Lane•Walnut Creek,CA 94598•(5 10)988-9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Consultant Company f r y�I6 Z��?. Protect Name SI-I Z <br /> Address i!-797 S tCl r UNOCAL Protect Manager a A c <br /> City 6 (� State Zip Code AFE# <br /> Telephone p / S��7SSS" FAX# ,,J S I Site#, City, State Z <br /> Report To 14�i ti am ler (�1� �f �k r��!!nom QC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A c <br /> Turnaround 1�Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water JAnal ses Re nested <br /> Time ❑ 2 Work Das (4 1 Work Da 1:12-8 Hours ❑ Waste Water , .70 I /L CcrLrI7 2 �l <br /> CODE- ❑ Mlsc Detect ❑ Eva[ ❑ Remed ❑ Demo[ ❑ Closure ❑ Other <br /> Client Date/Time Matrix # of Cont Laboratory � <br /> Sample f D Sampled Desc Cant Type Sample# Comments <br /> co <br /> 2 <br /> h f �0 A�4 far o <br /> ca <br /> 3 <br /> 4 S D>C� C'oi�O y 4S <br /> (D <br /> 5 <br /> �` 11 k IVA- >- <br /> 6 <br /> 7 <br /> 8 <br /> I <br /> 9 <br /> 0 <br /> 10 ca <br /> ryL <br /> ^4 <br /> 7 A <br /> Relinquished By L Date �/ /k? Time Received By 61V Date -t -'-11-Time W J <br /> Relinquished By DateQ-1-'-a Time Receive Date <br /> Time- <br /> Relin uishe Date Time Received BV Lab �'' �5 Date ` 7 ITime L��Z—J <br /> Were Samples Received in Good Condition?O Yes 0 No Samples on Ice? Q Yes❑ 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? ❑Yes 0 No If no, what analyses are stili needed? __- <br /> 2) Was the report issued within the requested turnaround time? ❑Yes 0 No If no, what was the turnaround time? <br /> AF:)roved by Signature Company Date <br />