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Chevron CaltromidRegion R • • • • <br /> + qLancaer Laboratories For ncaster Laboratorles use only <br /> MwequaGtycsasaence Acct # ��Q Sample#s �uC37�'1Cn SCR# <br /> $ <br /> Analyses Requested k p <br /> Facility# Matnx <br /> Preservati n Codes Preservative Codes <br /> H=KCI T=Thiosulfate <br /> Site Address a IN=HNO3 B=NaOH <br /> Chevron PM �,. _ Lead ConsuVAt,..- f \ S=H2SO4 0=Other <br /> v to c3 <br /> Consultant/Office m a c 11 [3J value reporting needed <br /> —G-R, inc , 6747 SieIra Dublin, Ca 94508 '5 0. 1 \ ❑Must meet lowest detection limits <br /> Consultant Pq Mgr r a o possible for 13264 compounds <br /> Consultant Phone# AQC% KKI Fa <br /> o a 41 <br /> ZX# ❑ 8021 MTBE Confirmation <br /> 11�[S'f'� - - - coo ❑Confirm highest hit by 8260 <br /> Sampler 1�+r Li1 E $ 0 ❑ ❑Confirm all hits by 8260 <br /> Service Order# ❑Non SAR az _ <br /> CL + o 2 a o ti ❑Run oxy s on highest hit <br /> Date Time o o o w = z A m ❑Run_oxy s on all hits <br /> Sample Identification Collected Collected 0 U cn O m <br /> .{ 07 Xb<i I I `)CComments 1 Remarks <br /> O'�QS <br /> MW• s <br /> Relinqui by Date Time Date Time <br /> Turnaround Time Requested(TAT)(please circle) <br /> 72 hour 48 hour Date Time R ed by Date Time <br /> 24 hour 4 day 5 day "tt,VA)4 �b '�!b �4 ]YYO <br /> I <br /> gwsh y Date Time Re rved by 97 Date Time <br /> Data Package Options(please circle it required) <br /> 1avctS a s k 0 (0-UTZ <br /> QC Summary Type <br /> Type VI(Raw Data) ©Coelt Deliverable not needed Relinquished by Commercial Ca r r Receiv Date Time <br /> biN <br /> WIP(RWQCB) UPS FedEx the �y�, 5a <br /> Disk Temperature Upon Receipt C. Custody Seals Yes No <br /> 41Laricasterl-aboratones,Inc,2425 New holland Pike,119W 12425,Lancaster,PA 17605-2425 (71T)656-2300 0 Rev 7130101 <br /> Copies White and yellow should accompany samples to LancLaboratories The pink copy should be retained by the client <br /> r <br />