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f M fl4 r $ Rei GAol� `^"` � �r uand�l22 �� <br /> fscl. t.i s <br /> Consultant pang Getter--it an Tnc. <br /> jact Name <br /> AddressFoxrtter Unocal 65098 <br /> -- <br /> 6747 Sisyra Court, Suite J UNoe ProlciMi Manager: - <br /> City _ Hick Z+11ckeraon 91C-714-3205 <br /> Dublin Start CA Zip ode' AFC t1. - - - <br /> �� 945b$ - <br /> Telaphone, FAX #, <br /> 925--551--7555 925-551-7899 Site 9. City,State: 5g�8 5 U0 & Sb{f6 Pacific Ave. , StacktOn <br /> Repot 70: De.-inna L. Sam ler: V j � " i --- ,`CA 6 <br /> Ha diLn P �t-�/i 4_r, QG Data: a Level D{starrct 4 17 Level C U <br /> Tvrnarnund tb Work Da l-evOl$ © Level A U <br /> 3 U 5 Work mays Q 3 Work Da d Drinking Water <br /> 77rne. 2 Work Days C3 fwark Dal► Q 2-$Hours Analyses Requested <br /> Waslo Waterer n, <br /> CODE: ❑Mrsc, 0 Deleci U 5var 0 Rprried El Demol U Clasrfre 0 Other D f7 <br /> Client WOW= Matrix # Of Con[ Laboratory, � p <br /> SarnFte 3 D Sampled Desc Cunt TYP Sample 4 <br /> Comments <br /> 2 Nw,2.7 7 0xYC <br /> - — � r I MTBE, <br /> 3. TUA.llliQ LE <br /> , a <br /> t] <br /> _5 S <br /> TAMK 1,2Dc& - <br /> MW.AS )-fn ill6>z' //?,-o <br /> 7. - <br /> 9 <br /> 10. a <br /> R4IIRiirJrshe 13ybatal <br /> ldtI7 Time-/FOXReceived 13 -1 <br /> Date G / Time Gt � r <br /> Relinquished By Data Time. Received By. Date z <br /> ` Time <br /> Aoliitqulsltied By date Time Received By Lab Dale Time. <br /> Were Samples Recelved In Good Condition? u Yes Q Na Sarriplcs art Ice? 7 Y4s {]No Metff;xi at Sliiprnent <br /> To be completed upon receipt of report - Nage of <br /> 1 y Woro the analyses requested on the Chafn of Custody reported? Q Yes U NO if na, what analyses are sli11 yeded? <br /> 2)Was tho report issued wt[liln the requested turnaround limo? U Yes 0 c no,what was the turnaround time9 <br /> l tprova by !� L C_ - <br /> .�Signature�-- oitipany�/�. a <br /> _-� 17at0 <br />