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int - <br /> U3, <br /> u b6oUiesapeakeDrive•HedwoodCity,LA 94063•(415)364-9600 ❑ 18939120th Ave,N E,Suite 101 •Bothell,WA 98011 •(206)481-9200 <br /> IVA L . _ Q 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 �CrJProject Name CJ g <br /> Address a UNOCAL Project Managerjo <br /> City r> State `jZip Code--=-- Release# S k <br /> Telephone ��� C 3 f ! f FAX# %���`� 3 1 Site# 6, �G I 7( 7 f��c 1 I a <br /> _ U <br /> Report To ISameler C �!-�- QC Data ❑ Level D (Standard) ❑ Level C IJ Level l3 ❑ Level A <br /> Turnaround ❑10 Work Days 5 Work Days 3 Work Days ❑ Drinking Water Anal ses Requested a <br /> Time ❑ 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demo! ❑ Closure ❑ Other <br /> Client Date/Time Matrix #of Cant Laboratory , ter ] <br /> Sample I D Sampled Desc Cont Type Sample# A Comments <br /> // L, <br /> 2 <br /> 21 03 <br /> 4 <br /> 0 <br /> m <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br /> L <br /> 0 <br /> f <br /> �/ ' Received B Date Time <br /> Relinquished syr- - , � Dater��_�l� Time/' --' -� <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Lab Date ]Time <br /> Were Samples Received in Good Condition?�s lQ No Samples on Ice? ❑Yes�o Method of Shipment C�/' Page of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes❑No If no,what analyses are still needed? <br />- - 2) Was the report issued within the requested turnaround time? a Yes a No if no,what was the turnaround time? <br /> Approved by Signature Company Date <br />