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1 • 0 / ` • R1:111 • kz = •0 • <br /> Lamaler Laboratories For Lancaster Laboratories use only <br /> Kfffequabty15d5cmYm Acct # Sample# SCR# <br /> Analyses Requested <br /> Facility# Matrix Preservation Codes preservative Codes <br /> Site Address g� QPSH=HCl T=Thiosuifate <br /> N=HNO3 B=NaOH <br /> Chevron PM SC 14 RAN Lead Consultant O/ 12 5 � S=H2SO4 O=Other <br /> Consuitant(Office - #�(}/� a a a ❑ 3 aro ❑J value reportIng needed <br /> Consultant P Mgr a = N ❑Must meet lowest detection linitis <br /> 9 possible for 8280 compounds <br /> U ❑ Z <br /> Consultant Phone# j4~ f~Q Fax# q j - -l}��� ❑❑ `o g °` ❑ 8021 MTBE Corfimaation <br /> Sampler !J d }I' ❑ E w S & N 13a'^ ❑Confirm highest hit by 8280 <br /> Servace Order# ('77 � y u i` ❑Confirm all hats by 8260 <br /> � �❑Non SAR a z �, <br /> Date Time _ © +5 p E3Run_oxy s on highest hit <br /> Sam le Identification Collected Collected O m (--� .� ©Run_oxy s on all hits <br /> 2'1 ^Z x Comments 1 Remarks <br /> f f It ��rr.�r tlah,'r5 If3� <br /> Ykf 21- n Z 3-rcx 91M 7 r <br /> - 77A z�c�►, rO6Su,4 <br /> H,- 1TAr}�A�J�Er r� <br /> T <br /> 1242 f SooZA rk <br /> ah 2 1400 <br /> vi - nZ <br /> � <br /> Relinquish d by Date Time byr*6(AV1fA Tlrrre <br /> Tumaround Time Requested(TAT)(please circle) r r <br /> ile ATO <br /> t�p <br /> 72 hour 48 hour 6 i quis b \ a Time y Time <br /> 4 day 5 day 1 " f <br /> Data Package Options(please circle 8 required) Iinquis 6y U a Date Time Received by Date Time <br /> QC Summary Type I—Full <br /> T VI Raw Data Relinquished by Commercial Comer Received b <br /> Type ( ) ❑CoeR Deliverable not needed Y Date Time <br /> WIP(RWQCB) UPS FedEx Other <br /> Disk Temperature Upon Receipt C° Custody Seals Intact? Yes No <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,Pt&12425,Lancaster,PA 17605.2425 (717)6%2300 JoRev 7130/01 <br /> Copies White and yellow should accompany samples to Lance boratories The pink copy should be retained by the client. / <br />