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J ~•e4. .JA 1L1f1( u1 C&#,5Va y <br /> y <br /> For Latmarsti Laboratorie use only Y` <br /> -b <br /> y�W11e rs��oprace �/ "`QC AOM# —e-Y== Sample# 4 L� ., FO1,, <br /> 9th <br /> Anatyeas Requested <br /> Facility Al- SM-5775 GMMOS Go MaMx Pmservatlon Codes Preservadve Cortes <br /> Site Address 381 WEST KETTLEMAN LN, LODI,CA1141 H=Fic T=Thposuffate <br /> CL N=HNO3 B=NaOH <br /> Chevron PM RC Lead Consultant SECOMH S=HzSOa O=Other <br /> Consultanvotflce GR, Inc. 5747 Sierra Court, Suite J. Dublin,Caw 11a value reporting needed <br /> a.a. N O rlAust meet krwest detection limits <br /> Consultant Pr] Mgr ©tonna L Harding [deanrreegtir►c cosh) a.❑❑ © J possible 82W compounds <br /> Consultant Phone#' 925-551-7555 Fax P 22§-551-7M 551-7899------ 'S a o 8021 MTBE Confirmation <br /> Sampler—�, v ❑ g ❑ConSrrn highest hit by 8280 <br /> Senrios Order# ❑Non SAR Z ❑Confirm all hits by SM <br /> Z �1 [3 Run s on highest hit <br /> Run_ <br /> Date Tints � E — � ❑_ � $ � o g <br /> S8 a IdenSficatton ed Collected 0 O Am �` f ❑Run_oxy s on all hits <br /> ; 27 /swo Y le 1KI I Comments!Remarks <br /> • a x x �� <br /> IW L X X <br /> AWul 3 i <br /> owl lie. i.�iY I X- <br /> rNw-CMA iiix x <br /> rov- 6709 x x x x x <br /> x- Zzd <br /> a <br /> A/49 grK x K K <br /> - 3 <br /> MAP I x X1 Y, X <br /> TilMiro nd'nMe Requested(TAT)(please circle) Data Time <br /> STD TAT 72 hour � <br /> 48 hour <br /> 4 day 5 day Time Received by Date Time <br /> � r�tl � � �s <br /> Data Pac kage Options(please arch ff mquked) Relinquished tY Time Received by Date Time <br /> QC Summary Type i—run � <br /> �� �G(D �J�j� � j <br /> TYPO VI(Raw Date) 0Cook NOwerable not needed Reinquished by Cornmerdal Ca Revel <br /> e <br /> MP(RWQCB) UPS FedEx then <br /> Disk Temperature Upon Receipt C° Custody$gals ? es No <br /> LanCastar Laborstorlas.Inc.2425 New Hdiand Pike.PO Box 12425,Lancaster,PA 17605.2425 (717)1356.2300 <br /> Copies White and yellow should scoorrtpeny samples to Lancaster Laboratories The Ink 3460 Rev 7130101 <br /> p �should be retained by the dlern. <br />