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I� �' t� tl� ttttlltllltl� rI♦ Ittttttttl♦ � ltllttlttll♦ lilttlttlt� • tttttttttt� �: � <br /> r00ChesapeakeDriva Redwood City,CA 9 (41,,)364 11600 U 18939 12011,A,,,11,Suite 101 Bothell,WA 98011 • 401 9200 <br /> UNOCAL ' ❑ 819 Striker Ave,Suite 8•Sacramento,CA 95834 •(916)921 9600 U East 11115 Monlgoinery,Suite B•Spokane,WA 99206•(509)924 9200 <br /> U 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686 9600 U 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624 9800 <br /> Company NameC �V/2 Protect Name 0 C'eeq 7-rQ <br /> Address �a Cy UNOCAL Project Manager yj S <br /> City :J-ro- to Zip Code Release 1t /(�l <br /> c <br /> Telephone � FAX If - J Site It Q f�� v <br /> Report To /'/ ISampler �% sl QC Data lldlevel D (Standard) ❑ WWI ❑ Level B ❑ Level A <br /> a <br /> Turnaround 10 Work Days ❑ 5 Work Days ❑ 3 Work Days Drinking Water ses ed <br /> Time: ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc ❑ Detect VEval ❑ Remed ❑ Demol ❑ Closure VOther <br /> Client Date/Time Matrix # of Cont Laboratory <br /> Sample I D Sampled Dese Cont Type Sample It Comments <br /> L <br /> .ra <br /> i� {� �, I <br /> 3 1 <br /> 4 <br /> a� <br /> 5 ?- <br /> 8 <br /> 7 <br /> S <br /> 8 <br /> 0 <br /> 10 <br /> L <br /> 0 <br /> Relinquished By ate zZY Time U Received By <br /> Qate 734 <br /> Relinquished By a /2 i- �- Received B Date Time <br /> I 16 <br /> Relinquished 13v DataL-LTime Received B I Date Time �O� 17 <br /> Were Samples Received In Good Condition?❑Yes❑No Samples on Ice? Q Yes El No Method of Shipment Page ! of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes a No If no, what analyses are still needed? <br /> 2) Was the report Issued within the requested turnaround time? a Yes❑No if no, what was the turnaround time? — <br /> Approved by Signature _ _Company _ __ Date <br />