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UN(WAL Wo U 1319 Sinker Ave, Shite 9•Sacramento, CA 9*(916)92.1-9600 U East 11115 Monigarnery,bate Ii•bpokane, WA ayeun•�a<<+ acuv - <br /> O 1900 Bales Ave Suile LM•Concord,CA 94520•(510)686 9600 U 15055 S W Sequoia Pkwy Sudo 110•Portland On 97222• r )624 9600 <br /> Company Name Vt Project Name <br /> Address k 5rf, UNOCAL Project Manager <br /> City r State � Zip Code b Release II .- <br /> G <br /> a� <br /> Telephone �p��, FAX it Site It v <br /> Report T �f�. Sam ler Df� _ QC Data oRnevel D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> G� a <br /> Turnaround X,t]Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water JAnalyses Requested <br /> Time ❑ 2 Work Das ❑ 1 Work Da ❑ 2-8 Hours ❑ Waste Water <br /> CODE. ❑ Misc ❑ Detect ❑ Eval teemed ❑ Demol ❑ Closure QY Other <br /> Client Date/Time Matrix It of Cont Laboratory <br /> Sample 1 D Sampled Desc Cont Type Sample If Q� Comments <br /> t ✓ .q' A .die <br /> 0 <br /> l 2 �N� / do ° <br /> J <br /> 3 <br /> 3 <br /> 4 <br /> m <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 0 <br /> nx <br /> o` <br /> 0 <br /> Relinquished By Date �, TimeMo Received By Date Time <br /> a� <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date JTime I Deceived By Lab Date 1 fqb Time -75 <br /> Were Samples Received in Good Condition?Ct Yes 0 No Samples on Ice? C1 Yes Q No Metho Shipment Page_of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody report d? ❑Yes❑ No If no,what analyses are still needed? <br /> 2) Was the po!k sued within the requested turnaround time? Ye ] fy If na, what was the turnarotln tim ? <br /> Approved by r� ���I ____Signature _c _ _ _Company =_ �____ _ Date <br />