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Historicl1 ' f ' • ' 1Custody <br /> Lancaster Uorlories 0748 / For Lancaster Labora ones use only <br /> t/17'1telE°C�[ayisascerxe Acct.#: Group# I Sample#: p/ <br /> Please print Analyses Requested SCR#: <br /> Site/GloballD: —8G5 �a� 0 Preservation Codes Preservative Codes <br /> k <br /> Site Address: G5 SdJ wKt�y KJ� 11 Ylli!IS e-A H=HCI T=Thiosulfate <br /> [ N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC m S=H2SO4 O=Other <br /> � v <br /> ConsultantlOffice: El 401 Alberto Way,Suite B,Los Gatos,CA 95032 c 0 ❑J value reporting needed <br /> Fa_ 2 <br /> , <br /> 3800 Watt Avenue,Suite 210,Sacramento,CA 95821 0 ❑ L ElHPP Risk Assessment Detection <br /> Q <br /> v Limits <br /> Consultant Pr'.Mgr.: ols�v 776s � S <br /> ❑ <br /> o Chromatograms <br /> Consultant Phone#: (10gM_3t±7P Fax#: (r}I LO) q}g`3 5' m <br /> -DI Io <br /> Sampler: L, Gancl Ie--t7/ I). AVFbr_n,, n <br /> CL Z m V <br /> Field Repeat Top Time New R .0 <br /> Point Name Matrix Sample Depth Year Month Day Collected Field PtY/N O U a F- <br /> 04 6 tpplp N I>e I N I Comments!Remarks <br /> M w O� the 5jlr� cl t,/&#� . <br /> of T�'W xe o� /i <br /> e tri ulke—wTW <br /> 4,-MIN-s0111y, z,st ac <br /> 2 I�af�ie y�sl�h�ra C�e <br /> Turnaround Time Requested(TAT)(check box) ed by: Date Time Re by: ate Time <br /> Z 12;S� r/Jy 124 v7 i2:38 <br /> STD.TAT El 24 hour ❑48 hour <br /> ❑5 day El 72 hour El day elinquished Dat Time Received-t_Z0 G� Date Time <br /> IUote, rf d e ,r/ <br /> I ZY a7 �3.,4o y" � � �3;y <br /> Matrix Values Rep at Values Relinquished by: Date Time Received by: Dae Time <br /> S Suit T Triplicate Sample Duplicate sample <br /> W Surface Water or Groundwater T Relinquishe y ercial Carrier: a eived b : Dat Time <br /> + <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other l a O� <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> tS <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipts_!:L 5C° pH Custody S Is tact? Yes o <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev.1114/05 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />