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I <br /> I <br /> Cheyron California Region Analysis Request/Chain of Custody <br /> +Lam.aAerLFor ratOrleS La caster Laboratories use only r_b a y , y <br /> Wheli'yl,Ialriyaa5cab Ate.#' Sample# aD Ai sca# �"d {e Y <br /> Ot26 <br /> 0 `0q Analyses Requested <br /> Facility# SSO9-8632 G-R#386855 Global ID#T0607700670 Matrix Preservation Codes Preservative Codes <br /> W =HCI T=Thiosuliate <br /> Site Address575 GRANT LINE ROAD, TRACY, CA � N=HNO3 9=NaOH <br /> Chevron PM RC Lead Consultant SECORRH S H2SO4 O=Other <br /> w ❑ q ❑ value reporting needed <br /> Consultant/Office G-R, Inc, 6747 Sierra Court, Suite J, Dublin, Ca 94568 aa <br /> Deanna t_ Harding deenna rinc t:om a z c ❑Must meet lowest detection limits <br /> Consultant Prl Mgr n9 Q9 ) 1311 <br /> U i possible for 8260 compounds <br /> Consultant Phone#925-551-7555 Fax# 925-551-7899 o g o © 8021 MT6E Confirmation <br /> Sampler y ❑ ° $ ❑Confirm highest hit by 8260 <br /> E ❑ ❑Confirm all hits by 6260 <br /> Service Order# ❑Non SAR a Z "' ❑Run_oxy s on highest hit <br /> Date Time 1° om o Run oxy s on all hits <br /> Sample Identification Collected Collected (0 U 8 3 O � m ❑ <br /> I 2APo -..� x Comments 1 Remarks <br /> 31S <br /> X <br /> X <br /> - S 1 X <br /> (PA Xx <br /> Ax <br /> x X <br /> x <br /> Relinquished by Dta Time yTkne <br /> Turnaround Time Requested(TAT)(please circle) Lt <br /> �AT 72 hour 48 hour R e Time Received byDee Time <br /> 4 day 5 day /�/S J JJ <br /> Data Package Options(please circle If required) Relinquished by to Time R ived by D e Time <br /> OC Summary Type 1—Full � or►+�– <br /> Relinquished Commercial Cnaa <br /> Recai ate Time <br /> Type VI(Raw Data) ❑Coen Deliverable not needed UPS FedEx <br /> WIP(RWOCS) <br /> Disk Temperature Upon Receipt_AaC° Custody Seals ntact? es No <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,PgW 12425,Lancaster,PA 17605-2425 (717)656-2300 3480 Rev 7130101 <br /> Copies White and yellow should accompany samples to LancWboratories The pink copy should be retained by the client , <br />