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WIL R :1680,Chesapeake Drive•Redwood City CA 94063•(6540 9600 Ll 18939 1201h Ave,N E Suite 101 •Bothell,WA 98011 •( 1-9200 <br /> D 819 Striker Ave Suite 8-Sacramento,CA 95834-(916)921 9600 ❑East 11115 Montgomery,Suite B•Spokane,WA 99206• )924-9200 <br /> Q 404 N Wiget Lane-Walnut Creek CA 94598-(925)988 9600 O 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222 (503)624-9600 <br /> L, G ❑1455 McDowell Blvd North Suite D-Petaluma,CA 94954-(707)792-1865 <br /> Consultant Company 6e-7YZ,- )yfj-t-) le,c- --)-U G T/ �'2AGL Y- � �' Project Name <br /> Address E�S�� SI��rG C�k�f � Lfs 7 UNOCAL Project Manager Hr 41-)b Xc Q s <br /> City f ,.t b4 n State C eA Zip Code C AFE # <br /> Telephon<'?2 S) -C--v - rS"-� FAX # (y Lr)s-sj ����f Site #, City, State rC U I, c otic. .�/�y . s' e-,CTo ne4z_ m <br /> Report To A,-,/)r,q L, lJ h SamplerVeZQC Data Level D (Standard) ElEILev <br /> Level C Level B ❑ el A U <br /> 1�1�� ] !s 1 tl, <br /> Y <br /> Turnaround 0 10 Work Days ❑5 Work Days ❑3 Work Days ❑ Drinking Water Analyses Requested <br /> Time 2Work Days_,) ❑ 1 Work Day ❑2-8 Hours ❑Waste Water <br /> CODE: ❑ Misc ❑ Detect U Eval ❑ Remed ❑ Demol U Closure 0 Other <br /> Client Date/Time Matrix # of Cont Laboratory ��� Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> Z 15 G y " CJi- 4,ti -3 Vc,A 5, o <br /> r� <br /> 3 Mt. - ZZS i "i -' <br /> 2 <br /> 5 <br /> r <br /> 6 <br /> 7 <br /> 8 <br /> > <br /> 9 0 <br /> Y <br /> L <br /> 10 <br /> J <br /> Relinquished By , Date Time-"T Received By Date Time, u� <br /> Relinquished By Date Time Received By Date'& Time <br /> Relinquished By Date Time Received By Lab Date Time <br /> ere Samples Received in Good Condition9 U Yes ❑ No Samples on Ice? U Yes ❑ No Method of Shipment Page of <br /> 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 /> ')Was the report issued wilhin the requested turnaround time? ❑Yes ❑ No If no, what was the turnaround time? <br /> 9d by Signature Company Date <br /> i <br />