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Historicol Pipeline ' • • • AnalysisRequestlChainofCustody <br /> +LaxasterUffdWiles3�3 For Lancaster Laboratories use only <br /> °3z�Z 4 s t 'j /�. <br /> t�Vher�quahtytsasaence. Acct.#: � �`I� Group# ILg39Z� Sample#: ��?� �ZS <br /> Please print Analyses Requested SCR#: <br /> Site/Globat ID: -f <br /> Preservation Codes Preservative Codes <br /> r H=HCl T=Thiosulfate <br /> Site Address: N=HNO3 B=NaOH <br /> ChevronTexaco PM: ea Co�ultant:SAIC S=H2SO4 O=Other <br /> � v <br /> Consultant/Office: ❑401 Atberto Way,Suite B,Los Gatos,CA 95032 a J value reporting needed <br /> CL HPP Risk Assessment Detection <br /> 800 Watt Avenue,Suite 210,Sacramento,CA 95821 c ❑ z <br /> Consultant Prj.Mg//r.: Vt / / /� U ❑ ❑ > Elo emits <br /> / `o o c o� �o El Chromatograms <br /> Consultant Phone#: —C/ 7 Fax#: Ci w 0 m o n o <br /> : n <br /> Sampler \ N N N <br /> aZ m °O m o 0 cD to <br /> Field Repeat Top Time New o f4 m � = = _ <br /> uj <br /> Point Name Matrix Sample Depth Year Month Day Collected Field PtY/N C9 v m o <br /> r Comments J emarks <br /> r <br /> NU X <br /> S� 77 <br /> RelinquiS5Wshed b Date Time Received by: Date Time <br /> Turnaround Time Requested(TAT)(check box) t� *;fr>;fq law L.Cwl (PI-1212LI <br /> �� <br /> TD.TAT 1:124 hour El 48 hour <br /> ❑ 5 day ❑ 72 hour 1:14 day Relinquished y: Date Time Received by: Date Time <br /> Com, 1AZIA, 1003F' =E�X <br /> Matrix Values Repeat Values Relinquished by: Date Time Received b : Time <br /> S Soil D Duplicate sample Relinquished b mercial Carrier: eived by: Dae <br /> W Surface Water or Groundwater T Triplicate Sample tTim <br /> T TripBlank-QASample N Pre-Purge Sample UPSFedEx Other <br /> R Rinsate Blank-QA Sample P Post-Purge Sample 94) <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt I j C° pH Custody Sea tact? es No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike, PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 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 />