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U �� U 680 Chesapeake Dnve•Redwood City, CA 94063•(650)30 U 18939 120th Ave,N E Suite 101 •Bothell WA 98011 •(2069200 <br /> U 819 Striker Ave Surte 8•Sacramento,CA 95834•(916)921- 0 0 East 11115 Montgomery Suite B•Spokane WA 99206•(50 24-9200 <br /> 0 404 N Wiget Lane•Walnut Creek,CA 94598•(925)988-9600 0 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222-(503)624-9800 <br /> ❑1455 McDowell Blvd North,Suite D•Petaluma,CA 94954-(707)792-1865 ,/�/ <br /> Consultant Company 6 f7 r O o �I Project Name 5 57G cl fi-1 l 7C/ x <br /> Address jl �j1�✓ Gt r>n �i 0 UNOCAL Project Manager <br /> C <br /> City q n�C.hG �,r tate �� Zip Code Tp AFE # Of 14 ,S <br /> Telephone e7&, G .1�j OG FAX # jI I,j f 7 Site #, City, State � l , y 70 JToclT-,r < CD <br /> Report ToC ir-a v Sampler �j J QC Data el D (Standard) ❑ Level C Cl Level B ❑ Level A v <br /> Turnaround AVWork Days ❑5 Work Days ❑3 Work Days ❑Drinking Water Analyses Requested <br /> a <br /> Time 0 2 Work Days ❑ 1 Work Day ❑2-8 Hours ❑Waste Water <br /> CODE: ❑ Misc ❑ Detect ❑ Eval ed ❑Demol ❑Closure ;AiDtWer <br /> Client Date/Time Matrix # of Cant Laboratory <br /> Sample I D Sampled Desc Cont Type Sample # Comments <br /> J 61a., 9041,730 0 <br /> 2 �' f l �/ •p ? 0 <br /> Q <br /> 3 <br /> 4 Q <br /> 5 } <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 0 <br /> co <br /> 10 o <br /> c� <br /> Relinquished By DatTi Rec the y Time a, <br /> t <br /> Relinquished By Received By Date Time <br /> I <br /> Relinquished By Received y a� n Date Time <br /> Were Samples Received in Good Condition? U Yes ❑ No Samples on Ice? ❑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 reported'? ❑Yes ❑ No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time'? ❑Yes ❑ No If no, what was the turnaround time) <br /> Approved by Signature Company Date <br />