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. Ci 680 Chesapeake Drive•Redwood City,CA 94066115)364-9600 d 18939 120th Ave N E,Suite 101 •Bothell,WA 9801 81-9200. <br /> U O��� e9Striker Ave,Ave,Suite 8•Sacramento,CA 95834•(916)921-9600 O East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924 9200 <br /> (D U 1900 Bates Ave Suite LM•Concord,CA 94520•(510)686-9600 U 15055 S Sequoia Pkwy Suite 110•Portland,OR 97222•(503)624 800 � <br /> Project Name <br /> Company Name �� fil nc e <br /> �, _ ��✓ �,C.T X11,f 'r_ �� l/ UNOCAL Project Manager GG/, lG "el <br /> Address �p , } -- <br /> Zi Code Release# r� !f�i <br /> City rViJC' � r� (State , p <br /> Telephone C �-' /� FAX.# �t �" 1 > 1 Site # t3 <br /> Report To (''a y^'� Sampler fr C �'"� QC Data evel D (standard) El Level C ❑ Level B ❑ Level A <br /> a <br /> Turnaround a 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water Anal ses Re nested <br /> Time ❑ 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours ❑ Waste Water Lbw <br /> CODE, ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other �7 <br /> "� <br /> Client Daterfime Matrix #of Cont Laboratory � Comments <br /> Sample 1 D Sampled Desc Cont Type Sample# <br /> 0 <br /> 3 0 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> Z <br /> 9 0 <br /> i� <br /> 10 0 <br /> c4 <br /> 6L� Date)- J5 Time 1(r J�1 Received B Date Time <br /> Relinquished B <br /> Relinquished By Date Time Received B <br /> Date Time <br /> Date Time Received By Lab Date E "!� Time 2J <br /> Relinquished f3 <br /> L s Received to Good Condition? .Yes Ll No Samples on Ice? U Yes No Method of St1 meat Page of <br /> Were Samples <br /> 1 <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on thei �umaSound time?reported? <br /> Ye❑yes s❑ No No nofwhawwasthelyses tumaaaund time needed? <br /> 2) Was the report issued within the requested � Date <br /> Approved by _ Sianature - - — - ----Company -�- <br />