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0 680 Chesapeake Drive•Redwood City,CA 94 415)364-9600 0 18939 12011 Ave N E Suite 101 •Bothell,WA 980110)481-9200 <br /> UNICHL <br /> (D ., <br /> 819 Striker Ave,Suite 8•Sacramento,CA 95 (916)921-9600 Q East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)666-9600 O 15055 S W Sequoia Pkvry,Sule 110•Portland,OR 97222•(503)624-9800 <br /> Company Name Y o TnQi /C Project NameL <br /> Address -ED 11.6f,0iG. U.f�✓'S– ���-c- Eo UNOCAL Project Manager AV <br /> City We'vo &'en't,,,4 State Zip Code /V zO <br /> Telephone /'g' /,-) FAX Site# <br /> a� <br /> Report To 4eEir ,'{[,5S tSampler QC Data 9 Level A (Standard) ❑ Level B ❑ Level C ❑ Level D v <br /> Turnaround ❑ 10 Working Days ❑ 2 Working Days ❑ Drinking Water JAnalyses Requested <br /> Time ❑ 5 Working Days X24 HoursiL <br /> ❑ Waste Water <br /> ❑ 3 Working Days ❑ 2 - 8 Hours ❑ Other <br /> Client Datefrime Matrix # of Cant Laboratory ,p <br /> Sample I D Sampled Desc Gont Type Sample # \Q Comments <br /> 3 �7 7r <br /> 4 <br /> - o <br /> 5 }i <br /> 6 <br /> 7 <br /> 9 <br /> 10 <br /> 0 <br /> Relinquished By Date 01W Time pf/4P Received B &:TTate 3 9 Time 01?4e a, <br /> Relinquished By I Date 6)3'1FV" Time OJ3S� Receiv Date Time � <br /> Relinquished B Date Time Received By Lab Date ITime <br /> Were Samples Received in Good Conditions O Yes d No Samples on Ice? ❑Yes© No Method of Shipment Page_of <br /> To be completed upon receipt of report <br /> 1} Were the analyses fequested on the Chain of Custody reported? ❑Yes O No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested'-imaround time? ❑Yes O No If no, what was the turnarourd time? <br /> Approved by Signature Company — Date <br />