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Histoncol Pipeline Potfialic AnolystsofCustody <br /> Laxaster 0726 ��� �-� j For Lancaster Laboratories use only r� <br /> Wh�qualty1Sascier ce. Acxt.#: f 5 Group# j VV j q j q Sample#: q �L4 Wa-a-�` <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: QY M�}P owS Lz(0C)_f',4,C[ Preservation Codes Preservative Codes <br /> it 1 14 Site Address: �ptJ[�/1 W , Q��Q L� C Q N=HCI T= NaOH lfate <br /> = N= HNO3 B=NaOH <br /> ca <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC d S=H2SO4 O=Other <br /> U <br /> ConsultanVOffice: ❑401 Alberto Way,Suite B,Los Gatos,CA 85032 c� ^' ❑J value reporting needed <br /> 3800 Watt Avenue,Suite 210,Sacramento,CA 85821 © z ElHPP Risk Assessment Detection <br /> Limits <br /> Consultant Prj.Mgr.: avm S �+bknyvi's o N ElCl <br /> o Cl ❑Chromatograms <br /> Consultant Phone#: qlu) 4CA ��G Fax#: QU �}9— ���� ` co c 0 o <br /> co 0 <br /> 6� m ' ❑ ❑ 7 n o0 <br /> Sampler: 'LL / M o2 <br /> co (D co <br /> O <br /> Z m m N � t2 f U <br /> Field Repeat Top Time New o w m = = _ = <br /> Point Name Matrix Sample Depth Year Month Day Collected Field ern+ U �- m � a a <br /> 0V O Comments!Remarks <br /> AM- N a d , Irl <br /> ti t0 X /C6V LA l K <br /> N�4- N I !c7 YY K ll C�� v� :5L* <br /> 7r lid cefe-eAb <br /> Turnaround Time Requested(TAT)[check box] n ed by: Dat calved b : Date <br /> TD.TAT El 24 hour El 48 hour 5 <br /> El5 day El72 hour El4 day el sh b :11 ate Time eived b to Time <br /> Matrix Values Repeat Values Reli fished by: _ --- e- Time Received by: te_ --Time <br /> S Soil D Duplicate sample <br /> W Surface Water or Groundwater T Triplicate Sample Relinquished by Commercial Carrier: Received by: Date Time <br /> T Trip Blank-QA Sampte N Pre-Purge Sample UPS FedEx Other z 3 r4,o- <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Reoeip G.+�laYSC° pH Custody 5 ntaCt? No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster, PA 17605-2425 (717)656-2300 4324.01 Rev.1114105 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />