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IRS <br /> Lamaster Mat. 1. 1 N 13 For Lancasbr Laboratorlea use only <br /> Where quakyisascknce. Sample 0: 4 o�d t-1 S 01 A/3 3 3 <br /> Analyses Requested <br /> Facility#: 4e444&)4,.-- Presetvatlon Codes Preservative Codes <br /> Site Address: A!2c zu, go- 6g 6„ ,t��,.�'L O g- � � N=HCl T=ThNaios ffate <br /> Chevron PM —40// Aww-j'd 14 Lead Consultant: 53p l c � S=H2SO4 Other <br /> Consultant/Office: J�-O N aLA4- 'Yn !K"F,+ AaLl <br /> r if a ❑J value reporting needed <br /> Consultant Pd.Mgr.: etection linft <br /> V Q o possible for r 8et 260 dcompounds <br /> Consultant Phone#: Fax#: J�ID o o <br /> ' 8021 MTBE Confirmation <br /> Sampler: tW►�+- ���rZ E 54� x 0 Confirm highest hit by 8260 <br /> Service Order#: ❑Non SAR: Z ,� �, 0 Confirm all hits by 8260 <br /> Field Repeat Top Time New o a p Run_oxy's on highest hit <br /> Point a i v H fL I O Run <br /> _,oxys on all hits <br /> Q Comments/Remarks <br /> ,�1`jLea-� GZa- <br /> Tu nd Time Requested(TAT)(please circle) Relinqu by Time Received by Date Time <br /> 72 hour 48 hour <br /> Relinqurs Date Time Received Date Time <br /> hour 4 day 5 day <br /> Data Package Options(please circle if required) Relinquished by: pate Tin e Received by: Dot a Tirtra <br /> QC Summary Type i-Full <br /> Type VI(Raw Data) OCoe@ Deliverable not needed Relinquished rdal Carrier. R by Date Tune <br /> WIP(RWOCB). UPS FedEx Otherxodal� h <br /> Disk Temperature Upon Receipt • C' o� 09 <br /> ' Custody Seals 7 Yes A 7 <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656.2300 3460 Rev.101P4101 <br /> Copies:White and yellow should accompany samples to LlIncaster Laboratories. The pink copy should be retained by the client. <br />