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UNOC#L O 680 Chesapeake Drive•Redwood City,CA 94063•(650)364-96 U 18939 120th Ave,N E Suite l01 •Bothell WA 98011 •(206)481-9 0 <br /> 819 Striker Ave,Suite 8•Sacramento,CA 95834•(916)921 96Q Ct East 11115 Montgomery,Suite B►Spokane,WA 99206•(509}920 <br /> Cl 404 N Wiget Lane•Walnut Creek,CA 94598•(925)988-9600 Cl 15055 S W Sequoia Pkwy,Suite 110•Portland OR 97222•(503)624 9800 <br /> U 1455 McDowell Blvd North,Suite D•Petaluma CA 94954•(707)792-1865 <br /> IConsultant Company f- ` Project Name ��� sfj, — C_ $ C s <br /> 'AddressUNOCAL97y7 Sieraz Protect Manager /V 1c K +C c am? <br /> City 12)64"4 State C Zip Code ?L{S6 a AFE # <br /> Telephone FAX # ?25- ,55. 7 7988 Site#, City, State 019 T -- S&1, <br /> C _w <br /> Report To Pze-c4ew Sampler PzeCAie X,t i K4"J_ QC Data Wevel D (Standard) 0 Level C ❑ Level B ❑ Level A v <br /> Turnaround ❑ 10 Work Days ) 5 Work Days 0 3 Work Days U Drinking Water Analyses Requested S <br /> Time U 2 Work Days 01 Work Day ❑2-8 Hours a_ <br /> ❑Waste Water �� <br /> CODE: 0 Misc ❑Detect O Eval U Remed 0 Demol 0 Closure ❑Other .� <br /> Client Date/Time Matrix # of Cont Laboratory ! i '� v <br /> Sample I D Sampled Desc Cont Type Sample # Comments <br /> 1 �A!- Z Z -01s5 Q,�• Z DA X ' 1 dykIY( cc a o <br /> o <br /> co�A <br /> 3/up-! - Ire - _ + <br /> -� x <br /> J <br /> 4 I Cole-lai 1� 'o <br /> 5 <br /> 6_0445'), _�a� ,� x <br /> 9 <br /> 0 <br /> 100 <br /> / Awfd Ca <br /> n <br /> J <br /> Relinquished By Date 1Z v/o Time S Received B Date/e 47Yb Time s i <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Lab Date Time <br /> Were Samples Received to Good Condition? ❑Yes 0 No Samples on Ice? U Yes O No Method of Shipment Page_ of <br /> To be completed upon receipt of report <br /> 1)Were the analyses requested on the Chain of Custody reported? LlYes © No If no, what analyses are still needed9 <br /> 2) Was the report issued within the requested turnaround time? ❑Yes 0 No If no, what was the turnaround time? <br /> Approved by ___--- Signature _ Company _ Date <br /> I <br />