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' y — <br /> u 680Chesapeake1,,,,•Redwood City,CA 94063•(415)364 9600 ❑ 18939120th Ave,N E,Suite 101 •Bothe]],WA 98011 • 206)481-9200 <br /> U1 O CAL ❑ 819 Striker Ave, Suite 8•Sacramento,C*34•(916)921-9600 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99209)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)6249800 <br /> F <br /> mpany Name &3Dfa o Project Namedress �1 622-d��aft Yo UNOCAL Project Manager <br /> City ZState Zip Code Release# C <br /> Telephone 7 - a <br /> P -� FAX#_ �����J Sitet-10 0/ v <br /> Report To w/r!�-� ISampler GI QC Dataevel D (Standard) ❑ Level C ❑ Level B ❑ Leve!A 9� <br /> Turnaround Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water Analyses Re-quested-1CL <br /> Time ❑ 2 Work Das ❑ 1 Work Pay 1:12-8 Hours ❑ Waste Water <br /> CODE- ❑ Mise ❑ Detect ❑ Eval yRemed ❑ Demol ❑ Closurethen <br /> Client Date/Time Matrix #of Cont Laboratory �{ <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> 1 41 V l� S o <br /> z Z o <br /> 3 ro <br /> 4 <br /> 0 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> 0 <br /> 0 <br /> Relinquished By Time '</ Received By Date Time ;' <br /> a� <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By I Date ITime I Received By Lab Date Time W7- <br /> Were Samples Received in Good Condition?❑Yes 0 No Samples on Ices ❑Ye.Method of Shipment61 <br /> Page of <br /> 4 <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Cham of Custody reported? 0 Yes O No 1f no,what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes❑No if no, what was the turnaround time? <br /> Approved by Signature Company Date <br />