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/� — Kari tydKA,'uiIVU•.uuwuuuU(y t�A 1)ti3*(4(5)364 9600 U 18939 120th Ave,N E Suite 101 •Bothell WA 9801 6)481 9200 <br /> lJU 819 Striker Ave Suite 8 Sacramento C 4. 916 921-9600 U East 11115 Montgomery,Suite B•Spokane,WA 992009)924-SY-00 <br /> V U 1900 Bates Ave,Suite LM•Concord CA 94520•(510)686-9600 U 15055 S W Sequoia Pkwy,Suite 110•Portland OR 97222•(503)624-9800 <br /> [A,ddress <br /> pany Name // <br /> 1L� ('ec\ � �� j Project Name r 0 ft ) UNOCAL Project ManagerL r State C Zip Code Release# <br /> Telephone ) FAX# S �[? (} Site# <br /> U <br /> Re ort To Sam <br /> ler SE e 1s er OC Data 1,Level D (Standard) ❑ Levet C ❑ Level B ❑ Level A <br /> Turnaround 10 Work Days U 5 Work Days ❑ 3 Work Days y L) Drinking Water [Analyses Re uested 0- <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours <br /> ❑ Waste Water <br /> CODE: ❑ Mlsc WDetect ❑ Fval ❑ Remed ❑ Demol ❑ Closure y Other <br /> Client Date/Time Matrix 1 #of Cont Laboratory <br /> Sample I D Sampled Desc Cont Type Sample# <br /> r p Comments <br /> �5 J <br /> 4 <br /> 3 <br /> 5 0 <br /> as <br /> 6 } <br /> I <br /> 8 <br /> 9 <br /> 1 Q 21, <br /> 0 <br /> �s <br /> 0 <br /> Relinquished B L .0 <br /> Relln <br /> q y eke c Date Time Received B7� co <br /> G{ Date 1 21 q Time 11 l r `t <br /> Relinquished By Date 11 Ll -- Time v U Received By <br /> Date Time <br /> Relin utshed B <br /> Date Time Received B Lab Date r I Z ( � Time 1 2' g 0 <br /> Were Samples Received to Good Condition?L1 Yes rJ No Samples on Ice? 1J Yes❑ No Method of Shipment Page,a ot-ti <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? IJ Yes a No If no, what analyses are still needed? <br /> 2) Was the report Issued within the requested turnaround time? fJ Yes CJ No If no, what was the turnaround time? <br /> Approved by _ Signature Company _ _ v Date r, <br />