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U 680 Chesapeake Drive•Redwood City,CA 94063•(415)364-9600 U 18939 120th Ave.,N.E.,Suite 101 •Bothell,WA 98011 •(206)481-9200 <br /> UNOCALU 819 Striker Ave.,Suite 8•Sacramento,CA 95834•(916)921-9600 U East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> U 404 N.Wiget Lane•Walnut Creek,CA 94598•(510)988-9600 Q 15055 S.W.Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Consultant Company: ri N Project Name: C,'rC <br /> tle (L SeArt) IQ <br /> Address: 7� SUN f b() C.rCte S-7e^-i 1:11464LOProjec"t�M+anager: � �s <br /> City: r-c U State: C Zip Code: r) LIZ AFE#: L <br /> c^� c <br /> Telephone: ��a 351> FAX#: (II L �IS� 5� Sitel,CState: V <br /> Report To: -J I SL J S k Sam ler. /LSTs /?e K )sVzy JQC Data:>l Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround d10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water ,Analyses Re nested a <br /> Time: ❑ 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc. ❑ Detect. KEval. ❑ Remed. ❑ Demol. ❑ Closure 110Other S <br /> Client Date/Time Matrix #of Cont. Laboratory <br /> Sample I.D. Sampled Desc. Cont. Type Sample# Comments <br /> ! looll) -e,I I - d)C� <br /> 0 <br /> ca <br /> �- 13 <br /> 4-r—-2 N <br /> s.�_� - ' p ]� y <br /> 6T-_ _ I d <br /> 7. <br /> 6. <br /> 9. <br /> 10. o <br /> 0 <br /> a <br /> � t, r J <br /> Relinquished By: Date:ll to � Time 16..3 6 Received B : Date/ Time: 6 3U <br /> a� <br /> Relinquished By: v Date//G Time: l 30 Received B Date: Time: t <br /> 3 <br /> Relin uished B : Date: Time: Received By Lab: Date////6r/5;7 Time: <br /> Were Samples Received in Good Condition? Yes U No Samples on Ice? Yes O No Met od of S Ipment Page_of_ <br /> To be competed upon receipt of report: <br /> 1) Were the analyses requested on the Chain of Custody reported? U Yes U No If no,what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? U Yes U No If no,what was the turnaround time? <br /> Approved by: _ _Signature: _ Company: Date: <br />