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80 Chesapeake Drive•Redwood City,CA 940415)364-9600 :1 18939120th Ave, N E Suite 101 •Bothell,WA 98011 ,)481 9200 <br /> 819 Striker Ave, Suite$•Sacramento,CA 95834•(916)921 9600 Zi East 11115 Montgomery Suite B•Spokane WA 99206•(509)924 9200 <br /> UNO*CAL 9't <br /> J 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686 9600 7 15055 S W Sequoia Pkwy Suite 110•Portland OR 97222•(503)624 980T <br /> Company Name Protect Name UGGa j —4 �,r,C�Tvt�Y y <br /> Address �G j j f rCSC ✓moo k UNOCAL Project Manager !JQ✓ti <br /> City q,7d16, State e )4 Zip Code Release# <br /> Telephone �J - _>� /31 Lf FAX# ,; /-/�'1 Site# c <br /> '~- f T <br /> Report To 6 y 6C(v, 57 Sam ler QC Data Level D (Standard) ❑ Level C Level B Level A <br /> Turnaround E1-(0 Work Das ❑ 5 Work Das ❑ 3 Work Das o- <br /> Y Y Y Drinking Water Analyses Requested <br /> Time rd'Z Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE, ❑ Mlsc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure Other <br /> Client Date/Time Matrix #of Cont <br /> Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> 3C) �Y t7x✓ 1`�� a <br /> c� <br /> m <br /> 3 <br /> 4 3 <br /> 0 <br /> 5 } <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> L <br /> 10 0 <br /> L <br /> 0 <br /> Relinquished DateXO-,,1-ty Time Received By Date Time <br /> Relinquished By Date Time Received By Date Time F <br /> Relinquished BV Date Mme I Received BV Lab Date 10/1/1 Time H10 <br /> Were Samples Received in Good Condition?M/Yes 0 No Samples on Ice? ❑Yes�J No Method of Shipment Page I—of J <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? Q Yes❑ No if no, what analyses are still needed? <br /> 2) Was the report Issued within the requested turnaround time? 0 Yes❑ No if no, what was the turnaround time? <br /> Approved by Signature Company Date <br />