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Historical Pipeline Podolio Analysis Requestl0hain of Custody LWaS.G1 db eS D For Lancaster Laboratories use only d3 2 2��3 l�3 vl#�quaftyisasclem Aoct.M 1 1`I 1 Group# 1 2g M Sampie#: &Y-2 (17 —3 Please print Analyses Requested SCR#: Site/Global ID: ,^ k"65ea YY L. _© Preservation Codes Preservative Codes H =HCI T=Thiosulfate Site Address: V ,�J N =HNO3 B=NaOH ChevronTexaco PM: VLea Consultant:SAIC S=H2SO4 O=Other Consultant/Office: 11401 Alberto Way,Suite B,Los Gatos,CA 95032 ❑J value reporting needed ,r�3800 Waft Avenue Suite 210,Sacramento,CA M21 c Z HPP Risk Assessment Detection l // .� V W Limits Consultant Prj.Mgr.: ti!/ _ ❑ ❑ o ❑ 0 o� jr ❑Chromatograms Consultant Phone#: _ Fax#: � 8— `m o Sampler: :3 $ u o M M M 0 Z o ib N In u" v Field Repeat Top Time new o o W m m = = a w Point Name Matrix Sample Depth Year Month Day Collected Flew PtY1N U ►- m a I Comments R2� FT 19�X 4— r 7;/2L I rig- 5 Turnaround Time Requested(TAT)(check box) Relinquished by: Date Time Received by: _ Date Time X STD.TAT El 24 hour ❑48 hour wi2 115 day 1:172 hour EJ4 day Relinquished 6ate Time Received by: Date Time 1L (lQ3 Ft�EX Matrix Values Repeat Values Relinquished by: Date Time Date Time S Son D Duplicate sample Relinquished b ercial Carrier: Re bed by: M21 _ Time W Surface Water or Groundwater T Triplicate Samples T Trip Blank-OA Sample N Pre-Purge Sample UPS FedEOther X R Rinsate Blank-QA Sample P Post-Purge Sample o M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt Lo+ `� C. pH Custody Seals In t? Yes o Lancaster Laboratories, Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev.1114105 Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client.