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UNOCALU 819 Striker Ave Suite 8•Sacramenio CA 95834•(916)921 9600 U East 1 1115 Montgomery Su,lp B•Spokane WA 99206•(509i 924 92UO <br /> IJ 1900 Bales Ave Sade LM•Concord CA 94520•(510)686 9600 ij 15055 S W Sequoia Pkwy Suite i 10.1'vrlfand On 97222•15031 674 9800 <br /> Company Name (lh �4.T' � Protect Name Gf-0Ar~Q OA—).xrk <br /> Address � -sUNOCAL Protect Manager�e„� -” <br /> City K)F,+w� State Q \ Zip Code qA� ; 70 Release H <br /> c <br /> ► <br /> Telephone FAX H Site 0 �iJ1x alS` t�to �[t�-t r�1.1 �c t tv 4 �hec4i {,ori v <br /> Re ori To �C 1 C ^+_tip. ISampler i QC Data VLevel D (Standard) U Level C U Level B IJ Level A <br /> a� <br /> Turnaround IJ 10 Work Days U 5 Work Days U 3 Work Days 1] Drinking Water Analyses Requested <br /> Time U 2 Work Das U 1 Work Da '2-8 Hours U Waste Water u <br /> CODE IJ Misc 0 Detect U Eval IJ Remed U Demol IJ Closure )� Other <br /> Client Dale/Time Matrix Hol Conl Laboratory <br /> Sample I D Sampled Desc Conl Type Sample H CarnrnEar�ts <br /> i. <br /> +� <br /> 17, ), �, t r r �, Oyy X X .5091738 �� �, , <br /> G, <br /> 1—)\ <br /> 3 �T 1 T - ` �, f1Ar FT <br /> " 3 <br /> t �, i,-(-, k � � 091 39 �la�,r- <br /> 7 —C ( 1 r� , I +41 [ /4 0 r <br /> 17� a�J' l Jv 5091241 <br /> ro <br /> 0 <br /> n <br /> ,n <br /> Relinquished By , ��r Date i%r ��s Time /A. ) Received By Date lune � <br /> +v <br /> Relinquished By Date Time Received By Date Tune E <br /> Relinquished By Date Time JI Received By Lab Dale Time <br /> Were Samples Received in Good Condition?iJ Yes U No Samples on Ice? U Yes U No Method of Shipment Page _Z-of_v <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? U Yes U No It no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? U Yes U No If no, what was the turnaround time? <br /> Approved by _ Signature _ Company _ Date <br />