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UU 680 Chesapeake Dnve•Redwood City CA 9400 415)364 9600 U 18939 120th Ave,N E Suite 101 •Bothell WA 98011 •10) <br /> 481 9200 <br /> NALC1 819 Striker Ave Suite 8•Sacramento,CA 958 J16)921-9600 J East 11115 Montgomery,Suite B•Spokane WA 99206• 924 9200 <br /> U 404 N Wiget Lane•Walnut Creek,CA 94598•(510)988 9600 Q 15055 S W Sequoia Pkwy,Suite 110•Portland OR 97222•(503)624 9800 <br /> Consultant Company f1 Project Name ° <br /> Address ZOZS UNOCAL Protect Manager r82 <br /> 6� erg <br /> City 3CIZ, State C# Zip Code %_)10 AFE# <br /> �i 'u _ C <br /> Telephone `>o5 4 FAX# C8`r-N Site#, City, State ! <br /> } U <br /> Report To � �O Sam ler 51L nh QC Data Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround10 Work Das ❑ 5 Work Das ❑ 3 Work Da <br /> Y Y Ys ❑ Drinking Water lAnalyses Re nested <br /> Time 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE,]N Misc ❑ Detect ❑ Eva[ ❑ Remed ❑ Demol ❑ Closure Other <br /> Client Datef ime Matrix #of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> ca <br /> 2 '7 0 <br /> .,a <br /> ca <br /> 3r'— 09WfS <br /> 4 <br /> �5 <br /> 5 <br /> 6 <br /> 7 <br /> B <br /> 9 <br /> 10 0 <br /> co <br /> 0 <br /> Relinquished By Date 9• 22 Time Received By Date Time J <br /> Relinquished By Date Time Received By Date -22 Time 09x36 s <br /> Relinquished B Date ?"2-"'Time Received By Lab Date Time 1030 <br /> Were Samples Received in Good Condition?❑Yes❑ No Samples on Ice? ❑Yes Q 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 ID 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 /> Approved by _ Signature _ ______ -- ___---_—Company Date <br />