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a 680 Chesapeake Drive•Redwood City,CA •(415)364-9500 O 18939 120th Ave.,N.E.,Suite 101 •Bothell,WA 96011•(206)481-9200 <br /> ❑619 striker Ave.,Suite 8•Sacramento,CA 9916)921-9600 O East 11115 Montgomery,Suite B•Spokane,WA 99206*924-9200. <br /> UN&AL <br /> ❑ 404 N.Wiget Lane•Walnut Creek,CA 94598•(510)988-9600 D 15055 S.W.Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)6249800 <br /> Consultant Company: j-� Project Name: 9 f <br /> Address: /1,51 UNOCAL Project Manager: <br /> rf <br /> City: 4 State: �- Zip Code: AFE #: .. <br /> C <br /> N <br /> Telephone: FAX#: — Site#, City, State: �j <br /> Report To: Sam ler: OC Data: ❑ Level D(Slandard) ❑ Level C ❑ Level B ❑ Level A �_ <br /> Turnaround ❑ 10 Work Das ❑ 5 Work Days 3 Work Das n. <br /> y Y ❑ Drinking Water Anal ses Requested <br /> Time: ❑ 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc. ❑ Detect. ❑ Eval. ❑ Remed. ❑ Demoi. ❑ Closure ❑ Other <br /> Client Date/Time Matrix #ofCont. Laboratory <br /> Sample I.D. Sampled Desc. Cont. Type Sample# Comments <br /> L <br /> O <br /> 2. to <br /> 3. p <br /> 4.j p • D ,, o <br /> 5 } <br /> 6. <br /> 7 <br /> b- <br /> 9. 2% <br /> 0 <br /> 0 <br /> Date: ,� Time: ,'S0 Receive at . '� Time: <br /> Relinquished By: <br /> Relinquished By: Date Time: Received By: Date: Time: <br /> Relinquished BY: Date: Time: lReceived By Lab Date:d4& Time: <br /> Were Samples Received in Good Condition?❑Yes❑No Samples on Ice? ❑Yes❑No Method of Shipment Pase 0-0 <br /> o be completed upon receipt o report: <br /> 1) Were the analyses requested on the Chain of Custody reported? a Yes Q 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 />