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Historical Pipefine Poirffofid AnalysisReqn.,jestlChain ! 1 <br /> AbLLTXaSterL&w&(ws 0760 For Lancaster Laboratories use only ' ! <br /> tie dC?IftytSaSER M. Acct.M Group# I �N M Sample#:�ZQt)W�(D ' a <br /> Please print 03 /Z Q l Analyses Requested SCR#: <br /> Site/Global ID; Preservation Codes Preservative Codes <br /> H= HCI T=Thiosulfate <br /> Site Address: N=HNO3 B= NaOH <br /> ChevronTexaco PM:M.Scott Mansholt Lead Consultant:SAIC m S=H2SO4 O=Other <br /> Consultant/Office: ' a�'�arte-�tos yeses-- �a�� ca Q ❑J value reporting needed <br /> ll <br /> y z X'HPP Risk Assessment Detection <br /> Limits <br /> Consultant <br /> Consultant Pd.Mgr.: im V El El J a <br /> c r, O N N ❑ 0 CW) -06 <br /> �. ❑Chromatograms <br /> CD <br /> Consultant Phone M %0(0"' 71 Fax M�� �iotio"—Jzu g m � El 2 o o <br /> Sampler.. fit..-� l L t!G u, � cn M <br /> Z 00 W N C) <br /> 00 C> CD CDO <br /> co <br /> E cu <br /> V4 cli <br /> Field Repeat Top Time Newct0 m i = CD <br /> Point Name Matrix Sample Depth Year Month Day Collected Field Pt YIN C7 U <br /> -- Comments!Remarks <br /> r I01 / I <br /> - 07031 <br /> id aM <br /> Turnaround Time Requested (TAT)(check box) eiinqui ed by: at f� a ived Date Time <br /> , STD.TAT ❑ 24 hour 1148 hour S <br /> ❑5 day L1 72 hour El 4 day uished ate Time Received by: 4 <br /> 0117 <br /> Time <br /> Matrix Values Repeat Values Relinquished b Received by: Date Time <br /> S Soil D Duplicate sample Relinquishedmercial Carrier: R ived by: Date Time <br /> W Surface Water or Groundwater T Triplicate Sample 3-1 <br /> T Trip Blank-QA Sample N Pre-Purge Sample UPS FedEx Other <br /> R Rinsate Blank-OA Sample P Post-Purge Sample <br /> M Miscellaneous(e.g..product sample) TemperaturelpH Upon Receipt �' C° pH Custody Sea tact? Ye No <br /> 0 <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 4324.01 Rev. 1114/05 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />