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Chevron Cafifornia Re ion Analysis RequestlChain of Custorly <br /> L ,,,�,,r}er t ..I.r�.•:�} e� For LangwterLabomilories use only <br /> ancasre yrsasdence Acct. :: I ol&(4 Sample#: q5 faI -(e t{„ SCR*._9 45Q33 <br /> r <br /> Analyses Requested <br /> Facility#: l T L �~� ,$' Preservation Codes rvative Codes <br /> H HCI T=Thiosulfate <br /> Site Addres,&3t� n3 B=NaOH <br /> Chevron PM:_Llanr 1��1? 1 ead Cooynsultant: 5= H2SO4 O=Other <br /> CansultantlOffice: /Y• /.C� f ❑ EI Must <br /> value reporting needed <br /> n li <br /> o Must meat lowest detectiomits <br /> Consultant Prj.Mgr.: am ;e=, I ►�:3_ _ o' m possible for 8260 compounds <br /> Consultant Phone#: 9/6" /45 Fax#: rte—1W �_ N O © 8021 MTBE Confirmation <br /> `O R ❑Confirm highest hit by 8260 <br /> Sampler: M � m © ❑Confirm all hits by 8250 <br /> Service Order#: ❑Non SARe <br /> E x $ o Q Run oxy's on highest hit <br /> Field Repeat Tap Time New m x A. � �, ❑Run_oxy s on all hits <br /> Point Name Matrix Sam le De th Year Month Da Ilected Field.Pt. m <br /> Comments!Remarks <br /> L11__Tj V <br /> Relinqurs ate Time Re � Date Time <br /> T d Time Requested(TAT)(please circle) v. <br /> ' i <br /> STD.TAT 72 hour 48 hour linquished by: ate Time Received by: Date Time <br /> 4 day 5 day <br /> Data Package Options(please circle if required) Relinquished by: Date Time Received by- Date Tune <br /> QC summary Type I–Full <br /> Relinquished by Commercial Carrier: Received by: D Time <br /> Type.V1(Raw Data) ❑Coelt Deliverable not needed l? <br /> UPS <br /> � ��� <br /> UPS FedEx Other. <br /> WIP(RWQCB) v <br /> �40 <br /> Disk Temperature Upon Receipt C. Custody ? s No <br /> Lancaster Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 3460 Rev. 10!04101 <br /> i <br /> Copies:White and yellow should accompany samples to Lan a, boratories. The pink copy should be retained by the client. rr i <br />