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® .] 680 Chesapeake Drive•Redwood City,CA 9,1063•(415)364-9600 ❑ 18939 120th Ave.,N.E.,Suite 101 •Bothell,WA 98011 •(206)481-9200 <br /> UNOCAL ❑ 819 Striker Ave.,Suite 8•Sacramento,CA 95834•(916)921-9600 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> ❑ 404 N.Wiget lane•Walnut Creek,CA 94598•(510)988-9600 ❑ 15055 S.W.Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Consultant Company: N Project Name: <br /> Address SO/- 6o14 C,CCte Sri -^ I ti Prot ectManager: s !� <br /> City: !-j G� Q)v State: C a Zip Code: j5 ) y AFE #: 5C <br /> r' I c <br /> Telephone: r �� s 25Sti FAX #: (FF,,/I L b5� 2�5 - Site #, City, State: r 2 <br /> Report To: 2V sJ I�6'_k.a5 Sam ler. /2,ST-7 Re ,�jSt(-, JQC Data:4 Level D (Standard) O Level C ❑ Level B ❑ Level A <br /> Turnaround ,9,'('10 Work Days O 5 Work Days O 3 Work Days I] Drinking Water Anal ses Requested a <br /> Time: J 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours _1 Waste Water <br /> CODE: J Misc. ❑ Detect. �Eval. FJ Remed. [ADemol. J Closure Other <br /> Client Date/Time Matrix # of Cont. Laboratory <br /> Sample I.D. Sampled Desc. Cont. Type Sample# p� Comments <br /> ca <br /> 0 <br /> 2r. - ,_N s� �- si <br /> 4f: r✓ �/ 01 O <br /> i — <br /> ST--� <br /> 15T-_ - / <br /> 7. <br /> 8 <br /> 9 <br /> 0 0 <br /> m <br /> �- `o <br /> Relinquished By:r Date:11/IJ ,� Time16..3c, Received B Date' 7Time: 1C30 <br /> a� <br /> Relinquished By: Dater✓ /G Time: 1720 Received By Date: Time: <br /> Relinquished By: Date: Time: Received By Lab: Date// 00 Time: <br /> Were Samples Received in Good CEZE <br /> ❑No Samples on Ice? Yes O No Met od of S ipment_,�� Page_of <br /> To be completed upon receipt of report: <br /> 1) Were the analyses requested on the Chain of Custody reported? J Yes IJ No If no, what analyses are still needed? _ <br /> 2) Was the report issued within the requested turnaround time? U Yes J No If no, what was the turnaround time? <br /> Approved by. _ _. Signature: _. ------Company: ______Date: __. <br />