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V680 Chesapeake Drive Redwood Ctl ,CA 940 5 364 9600 U 16939 1201h Ave,N E,Suite 101 Bothell WA 98011a 19200 <br /> UNOCAL <br /> n Vr O CA L U 819 Striker Ave, Suite 8•Sacramento,CA 95834•(916)921 9600 U East 11 115 Montgomory,Suite B•Spokane,WA 99206•{509 924 9200 <br /> ❑ 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686-9600 U 15055 S W Sequoia Pkwy,Suite 110-Porlland,OR 97222•(503)624 9800 <br /> Company NameG ✓� r Project Name16 <br /> 'h,Address 'ZJ a, act UNOCAL Project Manager ,ems n 9 l <br /> City -y State : }- Zip Code Release It DD <br /> Telephone FAX 414401_9�5 <br /> •- <br /> Site It U <br /> Report To �fXJ' 1SampIerLe_,J_rSSC QC Data evel D(Standard) Cl Level C ❑ t.eve! 8 ❑ Level A c <br /> LL <br /> Turnaround 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water [Analyses Re uesled <br /> Time. ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ W to Water <br /> CODE: 121Misc ❑ Detect Eval ❑ Remed 1:1Demol ❑ Closure � Other <br /> Client Date/Time Matrix # of Cont Laboratory J <br /> Sample I D Sampled Desc Cont Type Sample It ` Comments <br /> Z <br /> y- 1 ' Ga 1b,5 5- 12 -9 5 x -z <br /> r 2 C� 5, _22 ° <br /> 'V.e- 5—ton •q 2 <br /> r� 4 �� 0 <br /> .r 5 �� 2 <br /> -+-- 6 I <br /> 7 Z5, �L-7 <br /> 10 o <br /> �q <br /> Relinquished By Dale Time Received ate 2 <br /> IL <br /> ai <br /> Relinquished By ( - Tlme i� Received B Date Time ��b <br /> Relinquished B ate Time Received B Lab Dale Z ime <br /> Were Samples Received 1n Good Condition?0 Yes 0 No Samples on Ice? ©Yes G No Method of Shipment Page. of <br /> I <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? 0 Yes Cl No 1f no,what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? 0 Yes O No If no, what was the turnaround lime? <br /> Approved by Signature Company =_ V Date <br />