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Jill <br /> LdI1Cd5ter For Lanese Laboratories use only <br /> '� ( � Q �- 3 P, !c)l- A a Sample ?3 - 9 Qo r. 0 0 9 A10 <br /> Analytes Requested !�d 739 <br /> Facility It Matrix Prescrielon Codes <br /> Uor <br /> Prcr►a <br /> sertive Codes <br /> H=HCI T=Thios fie <br /> Site Address: 5 H=HNO3 B=NaOH <br /> Chevron PM: 134t MML(%VMWJ, , CA 94 S=HzSO4 O=Other <br /> ❑ 4 <br /> ConsultantJOftice: 0 J value reporting needed <br /> W <br /> z 8 r Must meet lost detection linft <br /> Consullanf Pry,Mgr: p poesbis for 8260 compowds <br /> 5 <br /> 925 551-755 925-551--1899- ❑❑ El Q C' <br /> Consultant Phone : Fax+i: `o o e+ 8021 WTBE Confirmation <br /> Sampler. . ° g <br /> E o o ♦ [3Conflrm Nghest hit by 82W <br /> 2 0 � $ ❑Confim►al flits by 8290 <br /> ci _ ❑ X $ $ J 0 Run_oxy9 on highest hit <br /> Sample Identification COWdled Col Ilected (D C) m° m O $ O - ❑Run_oxy9 on all hills <br /> Comments/Remark. <br /> -2 1Sr <br /> O - 1N-I 8. VC)Id ed <br /> Sr Pq 13H, <br /> Y� )r -XI 111LOd9 <br /> J - f <br /> - hep � : , i_ •o4vS" - - - --- <br /> • r►7�-tt i11f> <br /> Mw- a3k� <br /> ' ;l - RelnquRecelne TimeTu oe rime Requested(TAT)(Plea <br /> , me <br /> 72 hour 46 hour <br /> 24 hour 4 dad, 5 day PAW ui had Date Time ad by Date Time <br /> 21AW.ALL <br /> Data Package Options(Please circle if requaed) a Time Removed Date Time <br /> QC Summary Type 1•Full 7Y <br /> Type Y (Raw Date) F erclal Carrier:ClaM Dale Tme <br /> r.__ UPS F Other_ <br /> W IP(RWOCB).', . . t7 <br /> Temp�raGire Upon Receipt C° Cu Sella I <br /> 1_ancasW Laboratories,Inc.,2425 New Holland Pike,PO Box 12425,LarrcWer,PA 17605-2425 (717)e56-2300 4804,05 mwrni Rev.10/12M <br /> >>+Y.,M :_ ��rr Sri 3 a s;r rfr i;sr<4. �;;{ tGdpiaS:Vlfhita and�eNOw shelsi�aeeahpatiy samples to Lericaster.LaborAtories. The Pink Copy should be�etalned by the dierrt <br />