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U 680 Chesapeake Drive-Redwood City CA 94065)364 9600 u 18939 1201h Ave,N E Suite 101 -Bothell,WA 98011 -(2 1 9200 <br /> I U 819 SEnker Ave Suite 8•Sacramento,CA 958346)921 9600 U East 11115 Montgomery Style B•Spokane,WA 99206•(524-9200 +` <br /> U O'tAL U 404 N Wiget Lane-Walnut Creek,CA 94598-(510)988 9600 i1 15055 S W Sequoia Pkwy,Suite 110-Portland,OR 97222•(503)624 9800 <br /> Consultant Company 6.44 far ,'7� 0LA I V-'G Project Name q 3 -7 �, vier Av,-- rie— <br /> Address 31&q Gola, cc, ID1--,,,9- tG 2Ll0 UNOCAL Project Manager ga), <br /> u <br /> City °`1 0 C'M(-CN0V LState (-A Zip Code 95670 AFE # <br /> c <br /> Telephone &i 16 4, ` <br /> 1, - i30-6 1=AX # 6 tb 631 13 17 Site#, City, State 018-7, S Gk�, GA T <br /> Re ort To T v 1� t -(-Z ISampler �IJIo� e(-Z QC Data IA Level D (Slandard) IJ Level C ❑ Level B FJ Level A <br /> Turnaround 10 Work Days ❑ 5 Work Days FJ 3 Work Days IJ Drinking Water [Analyses Requested <br /> Time !J 2 Work Das IJ 1 Work Da IJ 2-8 Hours U Waste Water M <br /> CODE IJ Misc IJ Detect IJ Eval JJ Remed IJ Demol IJ Closure IJ Other <br /> Client Date/Time Matrix # of Cont <br /> Laboratory <br /> Sample I D Sampled Desc Cant Type Sample# Comments <br /> 1 U - 12-5'� S �n3q Soy U?rss X tS Tt3 -1 f <br /> ca <br /> 2 U - 12 - Cv, $ "�-'�* td Sa l X _ a <br /> 3 <br /> 4 V- 12 - 76 <br /> 5 U - l2 - 75.� S-�rp4 [(zo } <br /> 6 U - 12 - So.S S`��"/rr32 I <br /> X <br /> 7 v - 12 - 66 1�18 l X - <br /> a <br /> 9 o - 1?-- 9'S.S 5-9-;7 t 2-12- <br /> 10 <br /> 2210 u- 12-- 1 Uo. s E 2!,'7 I )C r 0 <br /> L <br /> a <br /> cis <br /> Relinquished By Date ��t�-d� Time � Received S Date,S-//-U Time ZS-or } `,' <br /> Relinquished By e"r" Date.J //-dt t Time .,60d Received B5/Date S^ � Time <br /> Relinquished B Date Time Received By Lab Date ITime <br /> Were Samples Received in Good Condltlon9 t Yes IJ No Samples on Ice? Yes U No Method of Shipment -50 Page sof - <br /> -To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? IJ Yes IJ No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? U Yes J No If no, what was the turnaround time? <br /> Approved by _ __ Signature _ _ _ Company _ __ __Date __ _ <br />