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Chevron • • <br /> Lancaster Laboratories Acct # Sample For Lancaster Laboratories use only /; <br /> le# "3 3 £�R# 7 S(oG8 <br /> j, 1 Wxye quality is a science <br /> Analyses Requested <br /> Preservation Codes Preservative Codes <br /> Facility# H =HCl T=Thiosulfate <br /> Site Address t � u C N=HNO3 B=NaOH <br /> � <br /> + cc S=H2SO4 O=Other <br /> [ <br /> Chevron PM Q('J+ W IVI Lead Consultant !�4 1�C �� T <br /> ❑J value reporting needed <br /> El <br /> Consultant/Office <br /> � N � ❑Must meet lowest detection hinds <br /> q 9 �Sd c 65 possible for 8260 compounds <br /> Consultant P Mgr 1r-1 U6( Y) S � <br /> Consultant Phone# q �i R I— Q4_OSZ <br /> Fax# q — g6 — �A_2L, o ❑ 8021 MTBE Confirmation <br /> CD <br /> o ti [3 Confirm highest hit by 8260 <br /> Sampler *-' E m ❑ ❑Confirm all hits by 8260 <br /> Service Order# ❑Non SAR a Z ❑Run—oxy's on highest nit <br /> Field Repent lop Time New 2 o o L Go <br /> a ❑Run—oxy's on all hits <br /> PointCL Name Matrix Sam le De th Year Month Da Collected Field Pt 0 U m <br /> W.�, x x Comments I Remarks <br /> al-Tabagl7 X x <br /> I <br /> I <br /> I <br /> � Relinqui5 by Date Time Received by <br /> Date Time <br /> Turnaround Time Requested (TAT)(please circle) i <br /> STD TAT 72 hour 48 how q s d by a Time Re by Date Time <br /> 24 hour 4 day 5 day 11�� <br /> Rehnquis 'IDate Time Received by Date Time <br /> Data Package Options(please circle 9 required) <br /> I <br /> QC Summary Type l—Full Relinquishe Com rcial Carver ;Ctod <br /> ed by D Time <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed 6 C <br /> UPS <br /> 7Fed Other <br /> WIP(RWQCB) U SealsI act Yes NDisk Temperature Upon Receipt 1CY <br /> 3460 Rev 10104!01 <br /> Lancaster Laboratories, Inc 2425 New Holland Pike PQ Box 12425 Lancaster PA 17605-2425 (717)656-2300 <br /> Copies White and yellow should accompany samples to Lancaster Laboratories The pink copy should be retained by the client <br />