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------------ <br /> Chevron California RegionAnalysis RequestlChainofCustody <br /> For Lancaster Laboratories use only <br /> y �kkkwenc�asteC L C 40125 Ac # 1 Sample 1t -7—) 1%z7--(2� SCR# ?gdVtsasoence <br /> Analyses Requested P <br /> Facility# �'3Z3 Z Matrix Preservation Codes Preservative Codes <br /> H=NCI T=Thiosulfate <br /> Site Address )(4k) 4��1a2_ 5CMfT4-jr& __f4'4C� _ _ N=HNO3 B=NaOH <br /> Chevron PM ifer 4, riz4d Lead Consultant 5=H2SO4 O=Other <br /> m ani y ❑J value reporting needed <br /> ConsultantlOffice 3��!7 lfxvt£rz.� ��� Kra r1•►�'H s c'� tGd �s7`7�7 o S ❑ a <br /> 2 '4 8 {3 ❑Must meet lowest detection limits <br /> Consultant Pr] Mgr Sr(_Va Zk0 o Z o ray possible for 8260 compounds <br /> Consultant Phone# }3?.!-cxl Fax# (glo at e-'Y� �❑❑ o � 2 E] � - 8021 MTBE Confirmation <br /> Sampler &r-4 s�6v i/ ❑ M w $ o ^❑ Confirm highest telt by 8260 <br /> Service Order# ❑Non SAR o Q z u, [I Confirm all hits by 8260 <br /> Q a + $ [3 Run_oxy s on highest hit <br /> Date Time 2 o o ro o �5 _ <br /> Sample Identification Collected Collected t7 U U) 3 O i- m I ❑Run axy s an all hits <br /> >< Comments 1 Remarks <br /> r�-YA --10 i��'-to D <br /> ...r-40 - ZS -r�" <br /> MW- A - 30 1t so <br /> - kf -% <br /> L0 10 <br /> Y 13C <br /> w- is rJ <br /> Turnaround Time Requested AT lease circle Relinquished by Date Time FReceivedby <br /> Date Time <br /> 72 hour 48 hour Relinquished y Date Time Date Time <br /> 24 hour 4 day 5 day j ply L y�o <br /> Data Package Options(please circle If required) Relinquished by ime Received by Date Time <br /> QC Summary Type I—Full <br /> Type VI(Raw Data) [ICoelt Deliverable not needed uish al Carrier Recei ed b a ime <br /> WIP(RWaCB) UPS FedEx Other <br /> c � <br /> Disk Temperature Upon Receipt! C° Custody Seals Intact? Yes No P <br /> Lancaster Laboratories,Inc,2425 New Holland Pike, ox 12425,Lancaster,PA 17605-2425 (717)656-23000 Rev 7130101 <br /> Copies White and yellow should accompany samples to Larer Laboratories The pink copy should be retained by the client <br />