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Cheyron La fo' r' _gjn Analysis Req _ i L rid' i, 1f( tod, , <br /> ,> Lamaster Laboratories For Lancaster Laboratories use only <br /> Maequalrryrsascerxe Acct # Sample# SCRIP <br /> Analyses Requested <br /> Facility# Matrix Preservation Codes , Preservadve Cods <br /> Site Address _ 1_ W�'`r Ke 14 Le�.1 n I T=Thiosutfate <br /> ++ .Co i N=HNO3 B=NaOH <br /> Chevron PM �2 t 6, .c-tn a CA v%Lead Consultant j CiK S=H2SO4 O=Other <br /> !! w m El value reporting needed <br /> Consultant/Office .�Qj 7 l� „, e o c © c <br /> o o :n i 8 ❑Must meet lowest detection limits <br /> Consultant Prj Mgr 11❑ U CO❑ possible for 8260 compounds <br /> x L O © 8021 MT norm <br /> Consultant Phone# 11 h S{�1,,cr f vC� Fax '-# �f SS 6! U + %y o g s o � BE Confirmation <br /> IV co Sampler i r, ` ,-, m ❑ w S g ❑ [3 Confirm highest hit by 8260 <br /> y = M ;E ❑Confirm all hits by 8280 <br /> Service Order# ❑Non SAR ¢ z <br /> [3F r ❑ + $ $ Run oxy s on highest lid <br /> Date Time o o _ c ❑Run oxy s on all hits <br /> Sample Identification Collected Collected U m r5 <br /> v2 I IE 7C Comments!Remarks <br /> i <br /> +1-1 1 4--r 1 <br /> I <br /> i <br /> T)Requested Turnaround Time Re A Relinquis y at Time Received by Date Time <br /> q (T (please circle) <br /> STD TAT 72 hour 48 ho Relinquished by Time Received by Date Tame <br /> 24 hour 4 day 5 day <br /> Data Package Options(please circle d required) Relinquished by Date Time Received by Date Time <br /> QC Summary Type i—Full <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed ReGnquishedCmercial Lamer Reserved by Date Time <br /> WIP(RWQCB) UPS F Other <br /> Disk Temperature Upon Receipt CO Custody Seals Intact? Yes No <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)65r>.2300 3460 Rev 7130109 <br /> Copies White and yellow should aocompany samples to Lancaster Laboratories The pink copy should be retained by the client <br />