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Chevron Califomial Region Analysis Request/Chain of Custody <br /> 410bncastu Laboratories r-q For Lancaster Laboratories use my <br /> Where c.wlttyisasoence Acct # d�UL Sample# � SCR# <br /> Analyses Requested <br /> Facility# g-6173 — Preservation Codes Preservative Codes <br /> p H=HCI T=Thiosulfate <br /> Site Address 301 tJ_kr-hRa A,-c L4 L14yC�lYf, - __ C3- <br /> N W HNO3 B=NaOH <br /> Chevron PMe-j�kh Com' fQao Lead Consultant S=H2SO4 o=Other <br /> ConsultantlOffice lir,r-7 L.1ljD& / 5-fob c ❑ c� [I J value reporting needed <br /> cu �, ❑Must meet lowest detection limits <br /> o 05 `. possible for 8260 compounds <br /> Consultant Pi) Mgr ,�L.d �L.�;s ® 13o ❑ w <br /> Consultant Phone# � Fax# 9ZI - 5�-� o N M a N 8021 MTBE Confirmation�i <br /> w °O o ti ❑Confirm highest hit by 8260 <br /> Sampler �, a 6�/,,,r�v.C� - N E m ❑ ❑Confirm all hits by 8260 <br /> Service Order# ❑Non SAR o z <br /> H r N <br /> a + ❑Run_axy's on highest hit <br /> Field Repeat To Time New <br /> m x <br /> P p o o z = I ❑Run_oxy's on all hits <br /> EN <br /> Point Name Matrix Sam le De th Year Month Da Collected Field Pt [7 U � m a 00 <br /> �24Mi2 Comments!Remarks <br /> at .A <br /> Relinquished by Date Time Received by Date Time <br /> Tumaround Time Requested(TAT)(please urcle) <br /> '4�-4;64V Z., <br /> CT D T 72 hour 48 hour R wished by Date Time Rete by Date Time <br /> 24 hour 4 day 5 day <br /> Data Package Options (please circle if required) Relinquished by Date Time Received by Data Time <br /> QC Summary Type f-Full Relinquished b rcial Carrier i Re ived by ate Time <br /> Type V1(Raw Data) ❑Coelt Deliverable not needed UPS FedEx Other (� <br /> WIP(RWQCB) <br /> Disk Temperature Upon Receipt Co ustody Se ct? Yes N <br /> Lancaster Laboratories, Inc,2425 New Holland Pike,ek,x 12425, Lancaster,PA 17605-2425 (717)656-2300 0 Rev 10/04/01 <br /> Conies White and yellow should accompany samples to Lancaster Laboratories The oink copy should be retained by the client W <br />