Laserfiche WebLink
Z680esapeake Drive•Redwood City,CA 9406 )364-9600 ❑ 18939 120th Ave,N E,Suite 101 •Bothell,WA 98011 •(20* <br /> 20 -9200 <br /> UNOCAL <br /> O ❑ 819 Striker Ave,Suite 8•Sacramento,CA 95834•(916)921-9600 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924 9200 <br /> • Ct 1900 Bates Ave.Suite LM•Concord,CA 94520-(510)686-9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 4 <br /> 7 -7 II 1� <br /> Company Name (f e'-ya e yG tr) (�!'o -5/;Cr r�!F; Project Name �/�/ r f 'J"f�. !7l �� "C_' '%G <br /> Address 3,� ;� i�/ ��1„ ��r 7r�G UNOCAL Project Manager106 <br /> City h%�'' i 'C, ,� .�r`� LY.t State t ��1 f Zip Cade % ;f ; Release# <br /> Telephone /, ; - �r / FAX# (%J� / _ / / Site# <br /> s <br /> Report To f "'i U �-'f Sam ler ,C/'i1 QC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A c <br /> Turnaround 10,f 1'0 Work Das ❑ 5 Work Das ❑ 3 Work Da <br /> Y Y Ys ❑ Dunking Water [Analyses Requested <br /> Time ❑ 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours ❑ Waste Water <br /> CODE- ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Date/Time Matrix #of Cont Laboratory ,t'�� <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> c� <br /> J <br /> 3 <br /> 4 0 <br /> a� <br /> 5 } <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 0 <br /> 10 <br /> 0 <br /> m <br /> Relinquished By—,----'!- G Date f Tim r(i i"� Received B -- - �T �- Date�� Time-- <br /> - Relinquished By - - Dai ----- <br /> Time Received B -- f Date <br /> - T i ,4! '� t i t , i - fJ `{ r <br /> Helin-uishedB ���� r Date Time ReceivedB Lab-, VI f l Date Time <br /> ' " <br /> Were Samples Received in Good Condition9 0 Yes 0 No Samples on Ice? 0 Yes❑ No Method of Shipment,_ Page of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reportedl ❑Yes 0 No If no,what analyses are still needed'? <br /> t 2) Was the report issued within the requested turnaround time'? ❑Yes 0 No If no, what was the turnaround time? <br /> ` a Approved by Signature Company Date <br />