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UNOCAL <br /> ❑680 Chesapeake Drive•Redwood City,CA 94063•({650)364-96001 ❑18939 120th Ave,N E Suite 101 •Bothell,WA 98011 •(206)481-9200 <br /> IVI'1 � <br /> ❑819 Sinker Ave,Suite 8•Sacramento,CA 95834•(916)921-9600 0 East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> 0 404 N Wiget Lane•Walnut Creek,CA 94598 iE(925)988-9600 ❑15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> .I f <br /> i •Petaluma,CA 94954. 707 792-1865 <br /> ❑1455 McDowell Blvd North,Suite D of �, ( } <br /> Consultant Company CaJtfu Q 1^c_ o7a 9.0 .86,0l Prolect Name <br /> Address. 6;4k4 UNOCAL Project Manager M� <br /> City AC 1.) State Ca. Zip Code AFB # <br /> Telephone •-� FAX # ! ig Site #, City, State �. S r, c <br /> 9L� s'�'� 4 Zr sr?,. <br /> ReportTob Qr Sampler Vr �1� �� QClData Level D (Standard) El Level C © Level B O Level A , v <br /> Turnaround 10 Work Days 5 Work Days C]3 Work Days ❑Drinking Water Analyses'Requested - <br /> Time: 2 Work Days ❑ 1 Work Day, ❑2-8;Hours Waste Water �D <br /> CODE: ❑ Misc 0 Detect ❑Eval ❑ Remed ElDemol 0 Closure I 13 Other <br /> Client Date/Time Matrix # of Cont 1 Laboratory Comments <br /> Comments <br /> Sample I D Sampled Desc Cont Type j Sample # y <br /> S C7 S: V6/4 Ci65f4y �( <br /> 1 U .. 10 i 1f�y� i�" « <br /> S X <br /> 2 U t <br /> 3 Q 1 Z 16;40 <br /> 0 ti S ->r it If <br /> x h o <br /> 4 <br /> 5 (A - lz: Y Y - <br /> 6 It <br /> S k <br /> 0 <br /> 10 U <br /> Relinquished By 417 ` Date VJAI �11ITime"1q,%4f, Received By tem ,� Time <br /> l <br /> Relinquished By Date !� Time Received Date Time <br /> Relinquished By Date Time Received By Lab Date Time <br /> ,� a <br /> Were Samples Received in Good Condition? 13 Yes Cl No Samples'on Ice? ❑Yes 0 No Method of Shipment Page=of <br /> To be completed upon receipt of report E �� <br /> 1) Were the analyses requested on the Chain of Custody reported? U Yes 0 No If no, what analyses are still needed? <br /> 2) Wast port issued within the requested turnaround ti el 0 Yes If no, what was the turnaround time? <br /> Approved by Signature Company Dat <br />