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Historical Pipeline PonYdfio Analysis RequestlChain of Custody <br /> LamasWr' oya}oe� 2308 <br /> 3O8 ( , 1 For Lancaster Laboratories use onlyKherC <br /> equakyaw6a`c ewe `+` Acct.#: I (L1 I Group#13�ID(Q Z] Sample#: 5078 Do- 5 <br /> Please print <br /> Analyses Requested SCR#: <br /> i a 1� -"V6-^ 1 J Z T? bOpoJ 272 3 Preservation Codes Preservative Codes <br /> Site/GlobalID: H = HCl T=Thiosulfate <br /> I « a N = HNO3 B= NaOH <br /> Site Address: nm IS <br /> ,C ,� = S= H2SO4 O= Other <br /> ChevronTexaco PM: ead Consultant:SAIC R iii <br /> consultant/Office: 1003 ��o1dW�� c oo []J value reporting needed <br /> _ a HPP Risk Assessment Detection <br /> ❑ ' ,/ I 1 Q� �q�l�(� o <br /> El co z Limits <br /> Consultant Prj. Mgr.: V`�I 1 L�wi L)Lt <br /> ` El ❑ J ❑ U <br /> o ❑Chromatograms <br /> �iN o i� � � � U <br /> Consultant Phone#: —63 b -701 Fax#: oD co <br /> ❑ 0 0 0 ' <br /> Q) TgLE <br /> o o Q <br /> Sampler: Seq.1 Q Z ° m m co com co <br /> a <br /> Field Repeat Top Time New m o o m ¢ a a F <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN CD v ~ m <br /> L/ 012- - O X �( Comments/Remarks <br /> !o I I k x <br /> 8 0yo <br /> _3 -— I 2s�12-o1-Z ?� a� <br /> 1335 I <br /> Q-o__-2P <br /> 1 LO x x <br /> Relinquished b to Time Received by: Date Time <br /> Relin <br /> Turnaround Time Requested(TAT)(check box) <br /> XSTD.TAT ❑ 24 hour ❑ 48 hourRelinquished by: Date Time Received by: Date Time <br /> El5 day EJ 72 hour El4 day <br /> Matrix Values Repeat Values <br /> Relinquished by: Date Time Received by: Date Time <br /> S Soil D Duplicate sample Relinquished by QQmmercial Carrier: ceived by: D to Time <br /> W Surface Water or Groundwater T Triplicate Sample <br /> T Trip Blank-Qed <br /> A Sample N Pre-Purge Sample UPS FEx Other <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt 1! C. pH Custody Seals Intact? s No <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 SaMP18S <br />