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❑ 680 Chesapeake Drive-Redwood City,CA 94 (415)364-9600 ❑ 18939120th Ave.,N.E.,Suite 101 *Bothell,WA 98011 •(246)481-9200 <br /> U A L ❑ 819 Striker Ave.,Suite 8•Sacramento,CA 958 16)921-9600 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99206 0 924-9200 <br /> ❑ 404 N.Wiget Lane•Walnut Creek,CA 94598•(510)988-9600 0 15055 S.W.Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-MM <br /> Consultant Company: Project Name: <br /> Address: UNOCAL Project Manager: <br /> City: ,�} State: Zip Code: AFE#: <br /> v <br /> Telephone: FAX#: Site#, City, State: 7� U <br /> Re art To: i t Sam ler: At-OOC Data: ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround ❑ 10 Work Days ❑ 5 Work Days 3 Work Days ❑ Drinking Water Anai ses Requested a <br /> Time: ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc. ❑ Detect. ❑ Eval. ❑ Remed. ❑ Demol. ❑ Closure ❑ Other <br /> Client 1 Date/Time Matrix #of Cont. Laboratoryn <br /> Sample I.D. Sampled Desc. Cont. Type Sample# Comments <br /> 1. P--S A (0-2, � <br /> 2. 6 ° <br /> to <br /> 4. � <br /> CS,p_ (a <br /> 9 Z-'11 2- �O� k <br /> IrtauF-i Ct )I- •XU+'r 't v;oiu.r110- fYL.kQ.111f1+lc.1'\.t`r`4 to Iq ��! C ort <br /> Relinquished By Dater / Time: Received B Dater- �� Time: <br /> a� <br /> Relinquished By: <br /> Dat41/--9 Tim 4) Received By: Date: Time: <br /> Relinquished i3 Date: Time: Received B Lab A Date ' 9 Time:1 <br /> Were Samples Received in Good Condition?a Yes❑No Samples on Ice? a Yes O No Method of Shipment Page ofJa <br /> To be competed upon receipt of report: <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes❑No If no,what analyses are still needed? _ <br /> 2) Was the report issued within the requested turnaround time? ❑Yes❑No If no,what was the turnaround time? <br /> Approved by: Signature: Company: Date: <br />