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i <br /> Chevron Californip Region Analysis Request/ hain' of Cust' dy <br /> I <br /> +LargVerL9w�Or1eS _ `� y�(,�(� , For Lancaster�aborato(�u only <br /> Wheret�uaflfyaascreric `D 3 C)l D Acct # �� L i VL[' Sample#4 r7 U�o�-J 1 " SCR# <br /> I <br /> Analyses Requested <br /> � $73`��� <br /> I <br /> 847 o B Matrix Preservation Codes Preservative Codes <br /> I Facility# � ; <br /> 508 CWTER-W DR, CA 1 114114 -1 IN I H=HC1 T=Thiosulfate <br /> Site Address 4 N=HNO3 B=NaOH <br /> RC SECORRH S=H2SO4 O=Other <br /> Chevron PM Lead Consult�fit <br /> nC , !i�lerra'Court, $Ulte3 U m cq C ❑J value reporting needed <br /> ConsultantlOffice 1 a N ❑Must meet lowest deteckm limits <br /> eanna ring enna nnc com z _ <br /> Consultant Pr M r possible for 8260 compounds <br /> 1 1 9 �� � � a � <br /> 925-551-7555 925-551-7899 •.44 <br /> Consultant Phone# Fax# `�o N AW <br /> 8021 MTBE Confirmation <br /> Sampler �j[h�k 11 ^�1 ,- W $ <br /> [3 Confirm highest lift by 8250 <br /> 0 <br /> © V z s� 3 �► p Confirm all hits by 6260 <br /> Service Order# ❑Non SAR ate Time Lo _ 0 Z � Ln R i a. o h <br /> ti [3 Run_oxy s on highest hit <br /> Sample Identification Collected Collected U 3 4 m 1 � '� a ci [3 Run oxy s ion all hits <br /> 113 03 1 1W I Comments 1 Remarks <br /> w- S tv <br /> ANN <br /> RelInqu by/� Date Time a <br /> Tu fid Time Requested(TAT)(please circle) , 3 <br /> DIN tp <br /> S D TA 72 hour 48 hour Re <br /> 2 ur 4 day 5 day 0MTU4 1A 1415 �9/MY <br /> 1 <br /> Data Package Options(please circle if required) NO Date Time Rece by is Time <br /> OC Summary Type I—Full 11/11114 <br /> r 11 d4 Y ! L p /W) <br /> T VI Raw Data Relinquished by Commercial Carrier R <br /> Type ( ) ❑Coett Deliwrrabte not needed ate Time. <br /> WIP(RWQCB) UPS FedEx AV I 0� <br /> Disk Temperature Upon Receipt f C. Custody Is I es No <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,P ox 12425,Lancaster,PA 17605-2425 (717)656.2300 3480 Rev Tf30/01 <br /> . Copi6s While and yellow should accompany samples to Lane Laboratories The pink copy should be retained by the client . <br />