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❑ 680 Chesapeake Drive•Redwood City CA 94 *16) <br /> 15)364 9600 :1 18939 120th Ave, N E Suite 101 •Bothell,WA 98011 •( 1 9200 <br /> A L ID 819 Striker Ave Suite 8•Sacramento CA 9583 921-9600 ❑ East 11115 Montgomery, Suite B•Spokane WA 99206•{5 24 9200 <br /> I <br /> ❑ 404 N Wiget Lane•Walnut Creek CA 94598•(510)988-9600 ❑ 15055 S W Sequaa Pkwy Suite 110•Portland OR 97222-(503)6249800 <br /> Consultant Company -r~f G :70 L Project Name M/Z y CZ- <br /> Address <br /> LAddress �(�y Cr <br /> IcJ (c, 02 ®y ZKG UNOCAL Project Manager /cc) c, /5/c-I <br /> City uq&SLG (CvdcV:t State C 14 Zip Code qJ670 AFB# <br /> pm <br /> Telephone f /3� FAX # 131/3l Site#, City, State OF-) c/7C Act/. /)V- Sff n co U <br /> Report To JSampler /Vi �l�"� OC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> TurnaroundWork Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking WaterAnalyses Requested <br /> 7-Tc,9- <br /> Time U 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours CA Waste Water �� <br /> CODE ❑ Mlsc ❑ Detect ❑ Eval _�fiemed ❑ Demol ❑ Closure ❑ Other <br /> Ghent Date/Time Matrix #of CantLaboratory <br /> Sample i D Sampled Desc Cont Type Sample Comments <br /> 2 Icy-y- ( 0 <br /> 0 <br /> 3 C <br /> J <br /> 4 0 <br /> 5 <br /> 6 <br /> 7 <br /> a <br /> s <br /> 10 <br /> 0 <br /> 0 <br /> Relinquished By Date73/-,�G Time Received B <br /> Time `1 <br /> a� <br /> Relinquished By D Time Received By Date Time <br /> Relinquished B Date ITime I Received B y Lab J Date - } Time <br /> Were Samples Received in Good Condition?❑Yes ID No Samples on Ice? a Yes❑ No Method of Shipment _ Page Jof_f <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes O No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes 0 No If no, what was the turnaround time? <br /> Approved by Signature Company Date <br />