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❑ 680 Chesapeake Dnve•Redwood City,CA 94CIAM0 15)364-9600 ❑ 18939 120th Ave,N E,Suite 101 •Bothell,WA 98011 • 81-9200 <br /> ❑ 819 Sinker Ave,Suite S•Sacramento,CA 9583 9i 6)921 9600 0 East 11115 Montgomery,Suite B•Spokane WA 99206•{ 924-9200 <br /> UN AL • <br />� ❑ 404 N Wiget Lane-Walnut Creek,CA 94598•(510)988-9600 ❑ 15055 5 W Sequoia Pkwy,Suite 110•Portland OR 97222•(503)624-9800 <br /> Consultant Company JoL Project Name <br /> Address r UNOCAL Project Manager <br /> City j6tate Zip Code f5670 AFE# <br /> Telephone `r�3 —)—Z'00 FAX# q !Site#, City, State <br /> Re ort To ��� C 'a`r Sam ler �1 QC Data evel D (Standard) ❑ Level C ❑ Level B ❑ Level A c <br /> IL <br /> Turnaround0 Work Days ❑ 5 Work Days 1:13 Work Days ❑ Drinking Water JAnalyses Requested <br /> Time 1:12 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water 1011A <br /> CODE• 1:1Misc 1:1Detect ❑ Eval -4<emed L1Demol 1:1Closure ther <br /> Client Dateffime Matrix #of Cont Laboratory <br /> Sample l D Sampled Desc Cont Type Sample# Comments <br /> n l M5 IJIZ3V, I1 P Gi ca <br /> ° <br /> 2 � 13 co <br /> J <br /> 3 ' <br /> 0 <br /> 4 — <br /> m <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 0 <br /> 10 co <br /> 0 <br /> Cd <br /> Relinquished By bate "Z710 Time Received By Date Time J <br /> a� <br /> Relinquished By Date Time Received By Date ' Time <br /> Relinquished B Date Time Received B Lab t Date 11 �7 Gft Time 7-n <br /> Were Samples Received in Good Condltlon'?.Zes 0 No Samples on Ice? 0 Yes 0 No Method of Shipment Page L of/ <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes E) No If no, what analyses are std! needed? _- <br /> 2) Was the report issued within the requested turnaround time? Q Yes 0 No if no, what was the turnaround time <br /> wproved by Signature Company Date <br />