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U H ❑680 Chesapeake Drive•Redwood City,CA 94063•(650)36. 1000 ❑ 18939 120th Ave.N E Suite 101 +Bothell,WA 98011 •(206, 9200
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<br /> • 0 819 Striker Ave,Suite 8•Sacramento, CK95834•(916)921-9600 f 0 East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924 9200
<br /> ❑404 N Wiget Lane•Walnut Creek,CA 94598•(925)988-9600 € ❑15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222-(503)624 9800
<br /> ❑ 1455 McDowell Blvd North,Suite D Petaluma,CA 94954•(707)792 1865
<br /> Consultant Company Gr��7'Pc,'. t�r�� 1�,c �4,011" 7 F6iiu y -sr Project Name ,y„�.,� (�;, S Y f# Cil t'
<br /> Address $ terra �;�, �-y . ,�� T " UNOCAL Project Manager O'Yr, Ao'�
<br /> City t��r F-, State (fr3 Zip Code e jy€ y,C;�, AFB #
<br /> Telephon q L 1 y"—S"/ C t (- FAX # ��j-'►St!-��j� Site ff, City, State c f3 c f � r��,� /�,[�, , _ _T
<br /> Report To �,,,,,� Sampler +/_�,�-kc s ��s /t�+r, „� 00 Data Level Q (Standard] C1 Level C O Level B , ❑ Level A U
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<br /> [Analyses Re uested - -
<br /> Turnaround 10 Work Days ❑5 Work Days ❑3 Work Days ❑ Drinking,Water Y q =` a-
<br /> Time. 2 Work Days ❑ 1 Work Day ❑2-8 Hours Waste Water -
<br /> CODE: O Misc 0 Detect ❑ Eval ,P€Remed ❑ Demoll ❑Closure ❑Other
<br /> Client Date/Time - Matrix # of ,Conk Laboratory Comments
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<br /> Sample I D Sampled Desc Cont Type �, Sample # _
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<br /> 10 L4 - I S-0-P r •r If it `I� f - -
<br /> Date J Time
<br /> Relinquished By ,/ - Dale Time �, S�~ Received By - - , ' _
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<br /> Relinquished By Date Time Received By Date Time
<br /> Relinquished By Date Time Received By Lab Date _ Time
<br /> Were Samples Received in Good Condition? ❑Yes ❑ No Samples on Ice? ❑Yes ❑ No Method of Shipment t € Page_ of
<br /> To be completed upon receipt of report
<br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes ❑ No If no, what_analyses are still needed?, `
<br /> 2)Wa report issued within the requested turnaround time? ' C3 Yes No If no, what was the turnaround time? -
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<br /> Anorc _ ___ = Signature �- Company Q
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