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U 680 Ghesapeake Uiivo•HLdwuud Gily GA 91U13•(41b)SU 1 UbUU U I 03`! i2U(1 i AvL N L,bullu 1U 1 •UU11101 4VA UUU I I {LUU) W I ;i2UU <br /> UNO r VRL (D '1�1,0619 Striker Ave,Suite 8•Sacramento,CA 95834•(916)921 9600 U East 11115 Montgomery Suite 8•Spokana WA 99206•(509)924 9200 <br /> 1900 Bates Ave,Suite LM•Concord CA 94520•(510)6B6 9600 U 15055 S W Sequoia Pkwy Suite 110•Portland,OR 97222•(503)6249800 <br /> Company Name�(�.�\�,`cC \�N �\�� C�\�., \�. Project Name <br /> 4 \ <br /> Address ��Q\ \�� \- QCL\�r� UNOCAL Project Manager <br /> City CQN�-zV�) State Zip Code`�''�� Release # <br /> c <br /> ( a� <br /> Telephone FAX # Site # <br /> Re ort To ��� m ler ���� QC Data Level A (Standard) ❑ Level B ❑ Level C ❑ Level D <br /> Sa � c <br /> a <br /> Turnaround 10 Working Days 1:12 Working Days ❑ Drinking Water JAnalyses Re uested <br /> Time. ❑ 5 Working Days 1:124 Hours ❑ Waste Water <br /> ❑ 3 Working Days ❑ 2 -8 Hours lit Other <br /> Client Date/Time Matrix # of Cant Laboratory Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> 407099 <br /> 2 Cry y t6 <br /> 3 407OC97 <br /> 4 \ 1`� `Lo� 4f1'7n�98 3 <br /> 6 �v� 40'10700 <br /> 7 ��.i�y 070701 <br /> 9 407n703 <br /> 10 4n"ln"" <br /> O <br /> tti <br /> Relinquished By � Date 15-f tl Time 1330 Received Date Time -J <br /> Relinquished By Date Time Received By_ Date Time <br /> Relinquished By Date Time Received ��� � Date Time m 3 <br /> Were Samples Received in Good Condition? Yes❑No Samples on Ice?XYes❑ No Method of Shipment Page \ of <br /> 31 <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) <br /> eeded2) Was the report issued within the requested turnaround time? a Yes O No If no, what was the turnaround time <br /> Approve Signature Company Date <br /> r <br />