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a3a-?l a -t' t ?-,-f3 <br /> *Laxzlff Labmtorie5 2254 1 For Lancaster Laboratories use only 1 ZS <br /> 1 q1dfity6asCOr€CL. Acct. 'F�' Group# IVQ 392(_ Sample#: <br /> del— <br /> Please print Analyses Requested SCR#: <br /> SitelGlobal€D: Preservation Codes Preservative Codes <br /> Site Address: Ife7 CL H=HCl T=Thiosuliate <br /> ChevronTexaco PM: ' K end consultant:SAIC m S=H2SO4 O=Other{ <br /> ConsultantlOffice: " Y ❑J value reporting needed <br /> 3800 Watt Avenue,Suite 210,Sacramento,CA 95821 c z HPP Risk Assessment Detection <br /> , '� // 0 <br /> Consultant P0.Mgr.: V jfl/ .,! (;h /)K U ❑ ❑ J A Lu Limits <br /> �, ❑Chromatograms <br /> Consultant Phone#: b_ !6� Fax#: �jGY i�/�i o o 0 0 <br /> Sampler �jID o = o M M <br /> a. Z °�° � t2 o m <br /> Field Repeat Top Time New o o w m z = = = <br /> Point Name Matrix Sample Depth Year Month Day Collected Field rt YIN U U H m a E a- <br /> �2 92 <br /> - >- Comments 1 Remarks <br /> Turnaround Time Requested(TAT)(check box) Relinquished by: Date Time Received by: e VAII W)y ate Time <br /> STD.TAT ❑ 24 hour ❑48 hour <br /> ❑ 5 day ❑ 72 hour ❑4 day Relinquishe by: Date Time Receive by: Date Time <br /> Matrix Values Repeat Values Relinquished by: Date Time I Received b : Date Time <br /> S Soil Duplicate sample Relinquished ercial Carrier: Received b <br /> W Surface Water or Groundwater T T Triplicate Sample Y: Date Time <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEX Other ` <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt j MCI pH Custody Seals Intact? es o <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.09 Rev.1/14/05 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />