Laserfiche WebLink
1432 For Lancaster Eaboratoriea use only <br /> Wfieequairyisa AAxt#: Ul n sample m S t'1 `13y-3g <br /> Please print Atnty:es Requested 9CFI#: <br /> Si gOobsl D: T ; $ wadi Codes Praaaroadw Codes <br /> Site Address. 35Sa (Zd, 'Ver o I H=HCl T=Thiigsulfate <br /> N=HNOS B=NaGH <br /> ChewonTexace PM:M.Scott Mansholt Lead Consultant C � S=H2SO4 O=Older <br /> CorrsuhanVOW'ce: 0401 Alberto Way.Sithe B.Las Gatos.CA 95032 ❑3 value ispoiiing needed <br /> 1938DD Wa#t Avenue,Sake 210,Sacramento,CAw821 © UO ❑HPP Risk Assessment Detection <br /> Corrsuttant P Mgr.:�]p W�1 S CIA ❑Limits <br /> Consultant Phone it: <br /> Sampler. m E <br /> Field Repeat Top Time New c � <br /> Point Name MatrixSam Year Month Day Cdledetf t=rlt:riYei C9 U ►- <br /> it Ar " 10 2k Iwo N k4 JAIN Comirimmts!Remarles <br /> LJ- NK NAr CrI 10 T-'L 1tgo 14 171, X ck yc <br /> 113 \N N tk <br /> 1! <br /> 4-.4b <br /> MSfMS}� {,mkt-� <br /> C Mw -{p <br /> ISM EODEO (511, <br /> -,-Mpf 1N 4 1 T <br /> tcltloq <br /> Tumaround Time Requested(TATk(check boxy R to Trine Rewe' try Dale Time <br /> '� TA 0 24 hour ❑48 hour ¢ <br /> ❑5 day 0 72 hour 0 4 day Rei wished Date Time Received by. Date <br /> z� i roo <br /> Matrix ValuesRepeat Values Relinquished by: Date Time Reoetvad by. Cale Time <br /> 5 Soil D Duo-"'sarspie Rel€n wished Reoeiv <br /> W Sur{aoe Water or Gmurr W.W T Tripllcake Sample q by rc a€Carrier. Qate Time <br /> T Trip Blank•OA Sample N Pre-Purge Sample UPS edF-x Other IQ <br /> R R€nsate Blank-QA Sample P Post•Pwge Sample 1,4!Z eT-1 0944ft <br /> M Miscellareeoua(e g.,prpdexi sarnple) Temperateupon Revwpt r,7�f C°L y�_p Custody Seals Ird.? NO <br /> Lancaster Laboratories.Inc.,2425 New Holland Pike,PO Box 12425,Lancaster.PA 17605-2425 (717)&96-2300 4324.01 Rev.1114M <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories_ The pink copy shotAd be retained by the client. <br />