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Cz—'> <br /> UElNOCAL <br /> 680 Chesapeake Drive•Redwood City,CA 94063-(650)364-9600 El 18939 120th Ave, N E Suite 101 •Bothell,WA 98011 •(206)481-9200 <br /> ❑819 Striker Ave,Suite 8-Sacramento,CA 95834•(916)9219600 ❑East 11115 Montgomery,Suite B*Spokane,WA 99206-(509)924-9200 <br /> O 404 N Wigel 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 f fry ,e u,, 1./SNC, Project Name <br /> ei- <br /> Address ,r,"QC77S� UNOCAL Protect Manager /-1r. G�� ' <br /> City ����, State (� Zip Code CIV AFE # <br /> Telephon l r) 5-S-1- '-- S-i FAX J�el �� �i� Site #, City, State �/3 7, *T 74 Iq <br /> Report To 1�L�c��nr� [,� L7-G1N ,, Sampler VL �� QC Data Level D (Standard) ❑ Leve! C ❑ Level B ❑ Level A <br /> Turnaround 10 Work Days ❑5 Work Days ❑3 Work Days ❑ Drinking Water Analyses Requested <br /> Time- 7 2 Work Days ❑ 1 Work Day ❑2-8 HourstL <br /> f�Waste Water �,4! CV <br /> CODE. ❑ Mise ❑ Detect ❑ Eval gWemed ❑ Demol ❑ Closure /❑ Other �,���.� <br /> Client Date/Time Matrix # of Cont Laboratory +��) <br /> Sample I D Sampled Desc Cant Type Sample # Comments <br /> 2 12 <br /> 4 A' e, Z — Z L r~ } K 0 <br /> 5 — 2 —60 G,LAS <br /> 7 <br /> 8 <br /> 9 0 <br /> 0 <br /> T <br /> 10 0 <br /> co <br /> J <br /> Relinquished By ✓r • Date�/ - Tlme,>, S Received By �' � Date �� Time f S" <br /> Relinquished By Date Time Received By Date Time s <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 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) is the report issued within the requested turnaround time? ❑ ❑ No If no, what was the turnaround time? <br /> Approve Sinnnti rra e�mmnn— <br />