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I <br /> ARCO F isCompany 7W �� ChsVustody <br /> 11anhCRcohfialdCocnpany 'task Order No <br /> ARCO Facility no City Protect manager .S� V Laboratory name <br /> Facil l �'U (Consultant) <br /> J <br /> ARCO engineer Telephone no Telephone no n Fax no ��� <br /> �i <br /> (ARCO) {Consultant) f! Consultant M6 3s/6 Contract number <br /> Consultantn me Address <br /> (Consultant)1717 <br /> S//Lam - fZ <br /> Matrix Preservation E❑l Method of shipment <br /> a3 m Q rn �� mQ rA p Wc�i1 ❑ <br /> CL m Sod Water Other Ice Acid a u a ate © m (��Ojy ❑ ❑ wcu <br /> ru C {O N <br /> m <br /> E LU <br /> O m� `� a <br /> m m w 1—'3 O v 1—w w cu w 1--2 <br /> r Special detection <br /> Limit/reporting ` <br /> h)00 as <br /> 3mo <br /> L_M -►f /zO Special QA/QC <br /> Remarks <br /> PjtOOHGT fiN L <br /> 1C��i, TDk <br /> 7*'"ti01`P6I IeD <br /> t�-PCS <br /> Lab number <br /> Turnaround lime <br /> Priority Rush <br /> 1 Business Day ❑ <br /> Condition of sample Temperature received <br /> Rush <br /> Relmquis by am r Date Time Received b 2 Business Days ❑ <br /> Relinquis by Date Time Re v by Expedited <br /> 5 Business Days ❑ <br /> n uishad by Dale Time Racefved laboratory Date Time Standard <br /> 10 Business Days <br /> Distribution White copy--Laboratory,Canary copy--ARCO Environmental Engineering,Pink copy—Consultant <br /> APPC 3292(2 91) <br />