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qw <br /> 0 680 Chesapeake Dnve•Redwood City,CA 949415)364-9600 ❑ 18939120th Ave,N E,Suite 101 •Bothell,WA 98011 • 81-9200 <br /> UCAL ❑ 819 Striker Ave,Suite 8•Sacramento,CA 9 •(916)921-9600 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99206•( 924-9200 <br /> ❑ 1900 Bates Ave,Suite LM•Concord,CA 94520,(510)686-9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> Company Name Project Name L <br /> y�.��, <br /> Address �� c r �i Y- f 7 ��G -- ,f UNOCAL Project Manager I <br /> City 4}]ck State (` Zip Code Release# <br /> Telephone 1(P -fit 5)136C FAX# /�� G I / j Site# z `�� ry kC !r c �` -14 <br /> .� E L 1 U <br /> Report To 5am ]er 1. <br /> OC Data ISL vel D (standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround0 Work Dais ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water [-Analyses Requested a <br /> Time 0 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc ID-Detect ❑ Eval Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Date/Time Matrix #of Cant Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> 0 <br /> 2 o <br /> 3 CU <br /> J <br /> 4 <br /> O <br /> 5 N <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 0 <br /> i� <br /> 0 <br /> Relin uished BY _ Date <br /> Time /6G� Received B Time ca <br /> Relinquished By Time Received By Date Time <br /> Relinquished BL DateTime Received B La Date�ld' '"00Time � v5 <br /> Were Samples Received in Good Condition? ❑Yes❑ No Samples on Ice? ❑Yes❑ No Metho of Shipment Page hof <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Cham of Custody reported? ❑Yes❑No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes a No If no, what was the turnaround time? <br /> 1 Approved by Signature Company Date <br />