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�Lancaster LaboratoriesFor abor$lories use only <br /> VOxye gualityrs a science Acct # I C G(0 S11 pie# a ~SCR# <br /> Analyses Requested b olo <br /> Facility# Matrix Pre ervation Codes Preservative Codes <br /> H=HCI T=Thosuffate <br /> Site Address a N=HNO3 B=NaOH <br /> ' S=H2SO4 O=Other <br /> Chevron PM or Lead Consuii ,,,.. <br /> 00 CD ❑J value reporting needed <br /> ConsultantlOf lice 0 o c ❑ <br /> - , , Z o :° o �Y [I Must meet lowest detection limits <br /> Consultant Pri Mgr m possible for 8260 compounds <br /> Consultant Phone <br /> "'# - Fax# a N 0 M-7555 92 8021 MTBE Confirmation <br /> Sampler ,//t:{y�Q� O�'C✓I d ❑ °� m = [3 Confirm highest hit by 8280 <br /> - - - - w L m © []Confirm all hits by 8260 <br /> Service Order# ❑Non SAR o a z' rE ta t R <br /> Q , m p ti ❑Run_oxy s on highest hit <br /> Date lime E a ° o x x W ❑Run_oxy s on all hits <br /> Sample Identification Collected Collected N 0 �- <br /> ,� _a Comments r Remarks <br /> 7_- <br /> �•- /3J0 �P <br /> nom , j <br /> !v- .r/ <br /> DS" <br /> 4z - /lf <br /> Roll shedpy Date Time Receiv Datey Time <br /> KSYD <br /> mnarou--n-d�Time Requested(TAT)(please circle) !7 <br /> TA� 72 hour 48 hour Reltngws D e Time R ed by ate Time <br /> 24 our 4 day 5 day <br /> Data Package Options(please circle it required) R m uishe y ate frl�me RepBrvedD Time <br /> ��7 {t1'1'�t�C dY 1nA <br /> OC SummaryType I—Full <br /> Relinquished by Commercial Carrier if y�Q Receive y ate nrrp <br /> Type VI(Raw Data) ❑Coalt Deliverable not needed UPS FedExer �� ` rZ4 <br /> qYQ)JJ <br /> WIP(RWQCB) <br /> Disk Temperature Upon Receipt _ tC° Custody Seals Intact? es Na <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2340 3460 Rev 7/30101 <br /> Copies White and yellow should accompany samples to Lancaster Laboratories The pink copy should be retained by the client <br />