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a unut nesa}�eakeUrrvF •RedwoodpitY Li910(415)3b4 9bU0 -1 18939 120th Ave,N E Suite 101 •Bothell WA 98011 •f' )481-9200 <br /> UU 819 Striker Ave Suite 8•Sacramento, CA •(916)921-9600 ❑ East 11115 Montgomery Suite B•Spokane,WA 99206 924-P200 <br /> L1 1900 Bates Ave,Suite LM•Concord,CA 94520•(510)686-9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•Portland OR 97222•(503)624-9800 <br /> Company Name �r c >a c-c 1 V L, Project Name <br /> ,Address a>, , I�, UNOCAL Project Manager <br /> City L LState L Zip Code ,r," Release# <br /> Telephone —S�� FAX # �,1 (e�� "C6�' Site# t v <br /> Re ort Ta Y Isampler ry e t_ t z QC Data Q Level D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround 10 Work Das I� 5 Work Das I] 3 Work Das I e- <br /> Y Y Y .0 Drinking Water Anal ses Requested <br /> Time 1 2 Work Das I.] 1 Work Da ❑ 2-8 Hours J Waste Water <br /> CODE: ❑ Misc 1A Detect ❑ E_val U Remed J Demol IJ Closure VA Other <br /> Client Date/Time Matrix # of Cont Laboratory <br /> Sample I D Sampled Des Conk Type Sample# Comments <br /> I � <br /> 1 L 'l� Sv4 �k�� ��G�r f o <br /> 11\\ <br /> 1 2 LV o <br /> 3 t C 1�.��J � J <br /> 4 <br /> 0 <br /> • 5 JC3' (D <br /> 6 <br /> 7 11�1;,4 <br /> ` 104L <br /> Q <br /> Ca <br /> .o <br /> Relinquished By a}'► c a( Date Time Received B G1�' Date 1117-11Time 1S <br /> a� <br /> Relinquished By UQ & Date 1IZI Time !2 03 Received By Date Time r <br /> Relln uished By Date Time Received By Lab , Date Time 1 '4 u <br /> i <br /> Were Samples Received In Good Condition? U Yes U No Samples on Ice? U Yes U No Method of Shipment Page I of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? U Yes U No If no, what analyses are still needed? ---- - -- <br /> 2) Was the report Issued within the requested turnaround time? U Yes U No If no, what was the turnaround time? -- -- — ----- <br /> Approved by Signature - _Company ___ __ _ __ __ Date _� <br />