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ON6804WpeaAW•RMW C,tW406JW)36M M IM 12t� N l 101�e11,U�11 - 8 - <br /> Tman ❑819 S Aker Ave,Suite 8•Sacramento,CA 95834•(916)921 ❑East 11115 Montgomery Suite B•Spokane,WA 99206•(509 200 <br /> i ❑404 N Wiget Lane•Walnut Creek,CA 94598•(925)988-9600 ❑15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> ❑1455 McDowell Blvd North,Suite D•Petaluma,CA 94954•(707)792-1865 GLOBAL TO T(�r 0 d x'011008 <br /> Consultant CompanyCit elex-R ?v Protect Name Forme Unacnl 45098 Warets <br /> Address 6747 Sieg-ra Court, uLte J UNOCAL Project Manager Nick Nirkiar4ion 916-714-3705 � <br /> City DiabI Lo State CA Zip Code 94-168 AFE # <br /> Telephone 925 .551-7555 FAX # 925-551--7P99 Site #, City, State �5096, 5400 & 5606 Pacific A-�rt ., Stcicktnn, C& <br /> Report To Dq rma L. H,,r tf tg Sampler QC Data S Level D (Standard) ❑ Level C ❑ Level B ❑ Level A U <br /> x <br /> Turnaround FIA 10 Work Days ❑5 Work Days ❑3 Work Days ❑ Drinking Water Analyses Requested <br /> Time ❑ 2 Work Days ❑ 1Work Day ©2-8 Fours <br /> lr7 Waste Water <br /> CODE. ❑Mlsc ❑Detect ❑ Eval ❑ Remed ❑Demol ❑Closure ❑Other �"� <br /> Z 4� <br /> Client Date/Time Matrix # of Cont Laboratory * �e��o Comments <br /> Sample I D Sampled Desc Cont Type Sample # <br /> t it f Roport S'S 1 repkq i <br /> 1 �- l �N rq €srL� 1r�4 f?160 Z'dtZi can o <br /> cc <br /> d � L <br /> 7 Oxy s-MTBE, m <br /> 3 £Act 4— T Is ' j `x t ( TBA,RIPE,ETRE J <br /> TAME, 1,2DCA 3 <br /> 4 .°t {f . r� 7 1/' _ a Vic)iCi 4 s 3C EDB 0 <br /> 6 <br /> f ,! <br /> i 0 <br /> ��4. lj � :T9 a«(3� �a O <br /> 10 L i r t t a °,aL2 --t 0 <br /> r <br /> Relinquished By ,� � r � � Date =, ' Time ��." J Received By t'� k- Date Time , <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Lab Date Time <br /> Were Samples Received in Good Condition? ❑Yes ❑No Samples on Ice? ❑Yes ❑No Method of Shipment Page_of <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) Was the report issued within the requested turnaround time? ❑Yes ❑ No If no, what was the turnaround time? <br /> Approved by Signature Company Date <br />