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' UNOCAL ❑680 Chesapeake Drive•Redwood City,CA 94069•(650)364-9600 ❑18939 120th Ave N E Suite 101 •Bothell WA 98011 •(206)481-9200 <br /> ❑819 Striker Ave,Suite B•Sacramento,CAI 95834•(916)921-9600 ❑East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> O 404 N W4ge1 Lane•Walnut Creek,CA 94598•(925)988-9600 ❑15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222•(563)624-9840 <br /> I II <br /> ❑1455 McDowell Blvd North,Suite D Petaluma,CA 94954•(707)792-1865 <br /> 4 it <br /> Consultant Company &Q fJJe,._ ar+ Sit,. z�jc),'s-q 2F.S& Project Name <br /> y II li � <br /> Address iarM Ce-)c,R,- Ste. ;�a �� UNOCAL Project Manager , N'Lc* JUtC Sdm /6 3z v T <br /> city 6 State Com, Zip Code , S AFE # <br /> t i <br /> Telephone C? FAX qZT)srl• �8 Site #, Clty, State l6b� ' C 'S/e -9k7fTr", v <br /> Report To Sampler 1/ S � °�4n OC Data , g(Level D (Standard) 0 Level C 0 Level B C1Level A U <br /> x i <br /> Turnaround p(10 Work Days 0 5 Work Days ❑13 Work Days ❑Drinking Water Analyses Requested a <br /> Time Ll2 Work Days 0 1 Work Day ❑{2-8 IHours�f Waste Water <br /> CODE. ❑ Mlsc ❑Detect ❑ Eval ❑ Remed ❑Demoll ❑,Cfosulre 0 Other <br /> 1 d H <br /> Client Date/Time Matrix # of Cont Laboratory Comments <br /> Sample I D ampled Desc Cont Type Sample # <br /> L <br /> c 3 VOA- Leo l (Zo .6. X <br /> 2 - 71 r 3 o i a 3a 3 I" j� X <br /> 4 1 o 1 143 S' <br /> s MV- s 9(41p 1 13 <br /> n � <br /> 6 ft), 11711 <br /> z MW A- r 113-f <br /> a raw- V/1,10 1$ 13,55' 3 "r� �. I� <br /> 9 3 ,I <br /> q 44 <br /> N�kf- ! Ib t SLt1 l - o <br /> I <br /> 10 Nrs, 10 �! D! rOvo � 3 U �!. I '� /C M <br /> / � f[f <br /> t II J <br /> 11 <br /> Relinquished By Date Time 1,?S-r Received By Date �� Time S S m <br /> Relinquished By Date h { Time Received By Date Time <br /> I[ <br /> Relinquished By Date j Time Received By Lab Date Time <br /> II <br /> Were Samples Received in Good Condition? ❑Yes ❑No 'SampIIles on Ice? ❑Yes 0 No Method of Shipment Page_of <br /> 11 <br /> • To be completed upon receipt of report I 1 <br /> I)Were the analyses requested on the Chain of Custody reported D Yes 0 No If no, what analyses are still needed? <br /> 2)Wa report issued within the requested turnaround time? If D Yes N0 If no, what was the turnaround time? <br /> Approved t Signature D <br /> re �� Company <br /> I it ll ` - <br />