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Histoficol ► • ' • - + • Custody <br /> Lancaster Ltoratorie 0748 For <br /> _ Lancaster Laboratories use only <br /> I'2detC • �J�— <br /> 1WE . p Sample <br /> Please print Analyses Requested SCR#: <br /> Site/Global ID: i { Q 21 44k 33 Preservation Codes Preservative Codes <br /> Site Address: 3� 56J�i+t in�Q� 11 yia is e,A H=HCI T=Thiosulfate <br /> t N=HNO3 B=NaOH <br /> co <br /> ChevronTexaco PM:M.Scott ManshoR Lead Consultant:SAIC Q> S=H2SO4 O=Other <br /> L U <br /> Consultantf0ffice: ❑401 Alberto Way,Suite B,Los Gatos,CA 95032 cry ❑J value reporting needed <br /> co <br /> 03800 Watt Avenue,,Suite 210,Sacramento,CA 95821 0 ❑ U, y El HPP Risk Assessment Detection <br /> Limits <br /> Consultant Prj.Mgr.: C hS }int s U J � � <br /> ❑Chromatograms <br /> Consultant Phone#: �� �� Fax#: (51ta) !9 <br /> o <br /> Sampler: L. Gwii6 i t l !� Awbdntn W = o M <br /> p Z N i" V <br /> c o <br /> Field Repeat Top Time New -o o <br /> co <br /> Point Name Matrix Sample Depth Year Month Day Collected Field YIN c7 U a co <br /> 7 W MIA, NIA 01 b 4 10010 N Comments I Remarks <br /> NIAN 01 list s�7r�, el c:1�n�P. <br /> oP T-Tf�ct � Illy <br /> GeW_rvr_j ulnewl a� <br /> Z64 IMS-40, <br /> G6�41�5�5�r <br /> meljws- -4d4 <br /> Turnaround Time Requested(TAT)(check box) 5&Ae ed by: Date Time Re :v b ate Time <br /> 2 f2;3� 1/214/0 12:38 <br /> STD.TAT El 24 hour L148 hour <br /> El 5 day El 72 hour El 4 day elinquished Datp Time Receiveate Time <br /> Na ?' rf d e �t1 - <br /> J2 �-r Y 13d,�0 3;y <br /> Matrix Values Rep at Values Relinquished by: Date Time 1. Received b : Dae Time <br /> S Soil D Duplicate sample Relinquishe y ercial Carrier: a eived b : Dat Time <br /> W Surface Water or Groundwater T Triplicate Sample _ <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other a O� <br /> R Rinsate Blank-QA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g.,product sample) Temperature/pH Upon Receipt,gof;.15C° pH Custody SeQ, tact? Yes o <br /> "7TM= 4324.01 Rev.1114105 <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)856-2300 <br /> Copies:White and yeltow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />