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-I: 680 Chesapeake Drive•Redwood City,CA 940 •(415)364-9600 ❑ 18939 120th Ave,N E,Swte 101 •Bothell,WA 98011 •( 481-9206 <br /> Us AL • ❑ 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 /> yqS-5Q� <br /> Company Name , 'f;4 r �Iv f,>t %r'r�� ei Project Name 441 <br /> Address i f Jf � )C,J UNOCAL Project Manager / <br /> // rfiri� c,c-- <br /> City C1 '.�U rr Y f<.` State �b'f Zip Code %rte Release# rJC) ,r�, <br /> c <br /> Telephone FAX# � f Site# <br /> r (r �� QC Data ( Level D {Standard} ❑ Level C ❑ Level B ❑ Level A <br /> Report To r' - Sam ler j <br /> Turnaround 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water Anal ses Requested µ° r- ; ' -, O` <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE- ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client DatelTime Matrix #of Cont Laboratory '� ! <br /> Sample i D Sampled Desc Cont Type Sample# Comments <br /> 2 y <br /> 3 y � <br /> J = <br /> 4 0 <br /> 0 <br /> 5 � - <br /> 6 <br /> 7 4 ; <br /> 8 <br /> 9 <br /> - - c <br /> 10 0 <br /> co <br /> 0 <br /> 1 .D <br /> fs , <br /> - Relinquished By r ,-a' ;, -� Date iC�� J : /Time.. Received B 1 Lb off/ Date /'f- �,71 ane <br /> Relinquished By ! -` ,// 1�'�/ Date,*(/i TIgie rte'1 Received B � � �r,.� �, Date /}f' Time F= ; ZZ <br /> Relinquished 8 f�� 'rf��� �,�� Date lTime Received BV Lab ���" Date 1°I� Time 121 3f, <br /> ' Were Samples Received in Good Condition?❑Yes❑No Samples on Ice? 0 Yes❑ No Method of Shipment 'S G Page ) of) <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes Q No If no,what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? a Yes❑ No If no,what was the turnaround time? <br /> IF f Approved by Signature Company Date <br /> r <br />