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O 680 Chesapeake Drive*Redwood City,CA 94063•(415)364-9600 O 18909 120th Ave.N E,Suite 101•BoW,WA 98011•(206)481-NW <br /> UNOCAL1 U 819 Stnker Ave,Sufte 8•Sacramento,CA 95834•(916)921-9600 U East 11115 Montgomery,Suite 8-Spokane,WA 99206•(509)924-9¢00 <br /> D 404 N Wiget Lane•Walnut Creek,CA 94598-(510)988-9600 O 15066 S W Sequoia Pkwy,Suite 110•Rxft d,OR 97722•(S00)824-9800 <br /> Consultant Company &Jh-V 2-Sd c7 5;y Project Name L/n r)<_4 <br /> Address 660/7" �'w T UNOCAL_Project Manager Lfr. 13 a,f, <br /> City u 6�i� State GcL . Zip Code 441s-6:7 AFE# (J <br /> m <br /> ele hone(9 Z.5-) 5S/-- Sss FAX# Slte#,Cl ty,State Jb �' c,, S a U <br /> Report To-be-Q.n n K Isampler Laidal T s QC Data a Level D(Staridano ❑ Level C ❑ Level B ❑Level A c <br /> Turnaround ❑ 10 Work Das A s Worts Das ❑ 3 Work Da <br /> Y Y Ys ❑ Dunking Water lAnalyses Requested <br /> Time: ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours f( Waste Water4 10 t, <br /> � <br /> CODE: ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other QW* <br /> Client Date/Time matrix #of Cont Laboratory '�' 7� t `o <br /> Sample I D Sampled Desc Cont Type Sample# Comments <br /> ...r 2 7J� ► r �o , r �'. <br /> 3 <br /> 3 <br /> 4 rv�cfr! >yG <br /> -err (�t.d .Lro 4 <br /> Z <br /> 6 <br /> 7 <br /> 8 <br /> 9 � <br /> 10 � <br /> Date a c? Time ��• Received B - Date 6' im8 <br /> Relinquished By m <br /> Relinquished By _ Date �A,()Time Reserved By Date- ? Time 1 Z '' s <br /> Relin uished Bmmmmomi <br /> } `" Date l7 Time Received B Lab D O/ Mme 15 : 15 <br /> Were Samples Received in Good Condition?0 Yes 0 No Samples on ice? 0 Yes❑No Method of Shipment Page—of_ <br /> To be completed upon receipt of report <br /> 1 Ore the analyses requested on the Chain of Custody reported? ❑�0 No If no,what analyses are still needed? <br /> o If no,what was the turnaround time? - ---- <br />