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O ❑680ChesapeakeDrive•Redwood City,CA 94063•((65})364-9600 O 189391201hAve, <br /> NE Suite 101 Bothell,WA98011 •(206),81.9200�, <br /> 0 819 Striker Ave,Suite 8 Sacramento CA 95834. 916 921-9� O East 11115 Moni ome Suite B Spokane,WA 99206 509 200 <br /> 0 404 N Wiget Lane•Walnut Creek,CA 94598•(925)988 9600 Q 15055 S W Sequoia Pkwy Suite i 10•Portland,OR 97222•{50224-9800 <br /> ❑1455 McDowell Blvd North,Suite D•Petaluma,CA 94954•(707)792-1865 <br /> Consultant Company Geer. r[rcxe7 Ind L$dD-CY. 8' _T1- Project Name F,��i!f 1.46 8 eq/ SS Z S <br /> Address 64q:� j�a�r•r4a Cb. <br /> 'dUNOCAL Project Manager - <br /> 1 H. 'V C.� N c&exoY- 34a <br /> City 2)u Al/ State Gam, Zip Code Q q S,4g g AFE # <br /> Tefephone�9Zs-� �sr �ss� FAX#C,10 r �rr? Site #, City, State 1661-;Oa ,bli c '9Wc 5 ��-a� [ria• <br /> LD <br /> Report To PeAshaqQr-d J:S7ampler4o�� T�9•l2o 1 OC Data Level D (Standard) ❑ Level C 0 Level B O Level A v <br /> x <br /> Turnaround10 Work Days O 5 Work Days 0 3 Work Days 0 Drinking Water Analyses Requested <br /> CL <br /> Time ❑ 2 Work Days ❑ 1 Work Day 0 2-8 Hours 91 <br /> Waste Water <br /> CODE: ❑ Misc ❑Detect ❑ Eval ❑ Remed ❑ Demol ❑Closure ❑Other �� �� <br /> Client DaterTtme Matrix #of Cont Laboratory ���o Comments <br /> Sample I D Sampled Desc Cont Type Sample # �� h <br /> C5 <br /> 2 -l7- 9111lot 1330 S `I X X 0 <br /> CIS <br /> 3 law-13 <br /> 4 M V- 1`'1' /6 0 111 g� <br /> 5 AW th 17.36 4- <br /> } <br /> 6 MU /I bo <br /> 7 Nkt-f--� 8,116(of fief <br /> 8 Mkr- I g V161 <br /> r ffiZ <br /> 9 W, 911 6101 1717- <br /> ca <br /> 5 <br /> io <br /> Relinquished By Date I Time r$S",J— Received By Date (c Time <br /> ue 94"T- <br /> Relinquished <br /> 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 0 No Samples on Ice9 0 Yes 0 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 />