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• • ' • ' ' • • • • ' - • • 1 • <br /> A&Lancaster Laboratoriesh For Lancaster Laboratories use only <br /> 1 iS a5t let tC@. G L IjAcct.#: Group# Sample#: <br /> 'e Where 9�m' <br /> Analyses Requested SCR#: <br /> Please print <br /> I � s` Preservation Codes Preservative Codes <br /> Site/Global ID: '-�;' ` t"L?7 t 7i7 `' 7!�7^ H=HCI T=Thiosulfate <br /> Site Address: �.� ��� �liifY2i:_.�1� �-1 N=HNO3 B=NaOH <br /> S=H2SO4 O=Other <br /> ChevronTexaco PM:M.Scott Macnshglt LLead Co uitant:�A�C� (,si 1v rtu,Ctr;� <br /> i ❑J value reporting needed <br /> Consultant(Office: �7 A0 YftibLito tllteq SOit B"tr15 <br /> ❑ z ❑HPP Risk Assessment Detection <br /> El 3800 Watt Avenue,Suite 210,Sacramento,CA 9581 o Limits <br /> �^ <br /> Consultant Prj.Mgr.: 'r Y r7t i� '�i t t) l4ct3� 7t `l i t-ti w El ElJ o ❑Chromatograms <br /> �,, t _ ��_ o 0 0 ❑ � � � � <br /> Consultant Phone#: 9G-#U7 7 1 Fax#: ��� � 3735 � °D � ��—, 0 0E0 0 0 � <br /> � �y1`, U <br /> Sampler: �` r\�_; } ! i ' 0. Z ° °Cc X LU W o o m <br /> Field Repeat Top Time New 2 0 Ham°- m a F <br /> Point Name Matrix Sample Depth Year Month Day Collected Field RYIN Comments/Remarks <br /> 77— �S 17 I 1 i <br /> Vv — <br /> U 07 ' 7� <br /> u <br /> it <br /> .... <br /> Relinqui by: �' Pati Time Recejded by/ -%-Date' Time <br /> Turnaround Time Requested(TAT)(check box) " i'; /ir; i . ;��ti <br /> STD.TAT 1124 hour ❑48 hourRelinquished b -" Date Time Received by: Date Time <br /> 5 day 1172 hour El4 day <br /> Relinquished by: Date Time Received by: Date Time <br /> Matrix Values Repeat Values <br /> S Soil D Duplicate sample Relinquished ommercial Carrier: Received by: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS + FedE Other <br /> R Rinsate Blank-QA Sample P Post-Purge Sample o H Custod Seals Intact? Yes No <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt C p Y <br /> 4324.01 Rev. 1/14/05 <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />