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6 680 Chesapeake Drive•Redwood City„(&94063•(41�)664 9b00 u IkJUJ9 110ui HVU ,i4! , V ❑ 819 Striker Ave,Suite 8•Sacramento,CA 95834•(916)921-9600 C3 East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924 9200 UNOCAL ❑ 404 N Wlget Lane•Walnut Creek,CA 94598•(510)988 9600 ❑ 15055 5 W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624 9800 ` Consultant Company ( Project Name r- � i f ,!i' t Address _�� Z-1) �i fr t i >> j T =f t f u t l UNOCAL Project Manager 1,0 k� ? _ city Cr i } JOS(,' State E� Zip Code 1'al;(? AFE# Telephone ' { t 7 5 �f 1 FAX# 1 S � Site#, City, State =, '-! I I I i Report To Sampler i IPC r Gc tA I i r� QC Data ID Level D (Standard) ❑ Level C ❑ Level B ❑ Level A � ? Turnaround �10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water [Analyses Re uested l f, Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water CODE: ❑ Misc ❑ Detect D-Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other Client Date/Time Matrix # of Cont Laboratoryommen s Sample I D Sampled Desc Cont Type Sample it 5 4 j L 6- 2 i "I J i yt C. !� 11�� ' 7 8 s 10 l : , 'r '?ref Date ' ';` f i f Time ' ',' ;Relinquished By By r '' r l Date I r X Time y Oo Received B ,f ,i %}it,� - / i Relinquished By i'' 1l Date 111- �, , Timt V o Received B �!d- �== Dat��ff�/`� Time � Time Received B Lab� 7� - '��!` F ” �, �i� Date f(/4�y Time Relinquished B -_ D t ++ Were Samples Received in Good Condition?0 Yes 0 No Samples on Ice? 0 Yes 0 No Method of Sh-n�,"Ihr Page_of To be completed upon receipt of report ' 1) Were the analyses requested on the Chain of Custody reported? 0 Yes 0 No If no, what analyses are still needed? V16' b 2);Was the report issued within the requested turnaround time? 0 Yes 0 No If no, what was the turnaround time? w Approved by Signature Company Date