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- HistodcolPor.Yofid Analysis RequestlChoin <br /> +Uncaster <br /> .. les 1211 For Lancaster Laboratories use only Uvf eeQL isasderx-e Acct.#: Group# 10'7 S(P q/ Sample#: 52 l!Pq5 7 J — S 7 Ic� <br /> Please print f Analyses Requested SCR#: � 3 O�y <br /> Site1GlobaIID:jPrI0AtTS PU�p <1-1r r 5L06Q'Tf�2t�3 Preservation Codes Preservative Codes <br /> H=HCI T=Thiosuifate <br /> Site Address: 3550 0 SDt,�'k �,,1t1-�, .. 1�P/.�i�l r`f. g N=HNO3 B=NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIL S=H2SO4 O=Other <br /> i V <br /> Consultant/Office: El 401 Alberto Way,Suite B,Los Gatos,CA 95032 Qc� ❑J value reporting needed <br /> Df5800 Watt Avenue,Suite 210,Sacramento,CA 95821 c <br /> ❑HPP Risk Assessment Detection <br /> # o ❑ ' Lu Z Limits <br /> Consultant P6.Mgr.: 1 k t t. 0 _ J a 0 <br /> Consultant Phone#: � +yiO" L I p �y o ` <br /> C. ❑ rk i U � ❑Chromatograms <br /> Fax#: q16- 17 !' 37 3 5- 0 m C 0 0 <br /> tt a? ,o ❑ ❑ m 0 0 0 M <br /> Sampler. i�� Y,`L - zi� 'rn = N N c¢� Z dId nod � <br /> Z „ co n 'n Cc- VXA+ r• <br /> O V, ti+"i <br /> Field Repeat Top Time rtew S 0 w m _ = i LuL <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YN 0 0 m <br /> O k Z Comments 1 Remarks <br /> Z — p N USS. 5'd icu <br /> W — _ 2 1U xri <br /> �l It <br /> Wl _ ! VA � <br /> r o x I f4 I X, <br /> p11ljl L`—'L! <br /> s l� <br /> )Ukzn of <br /> M� za'�- <br /> AW -(Q <br /> Turnaround Time Requested(TAT)[check box] R nquis by: at Time Received by: D to Time <br /> *STD.TAT El 24 hour El 48 hour <br /> 1. �� y "P _ — d <br /> ❑ 5 day ❑ 72 hour ❑4 day el is pate Time Received by: Dat Time <br /> X D() <br /> Matrix Values Repeat Values Relinquished f Date Time Received by: Date Time <br /> S Soil D Duplicate sample Relinquished by mercla!Carrier. R ved Date Time <br /> W Surface Water or Groundwater T Triplicate Sample 31�($ �� <br /> T Trip Blank-GA Sample N Pre-Purge Sample UPS FedEx Other !0. <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt 3-4 b p <br /> c° pH stody Seals Intact. es 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 />