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U �� U 819 Sinker Ave,Suite 8•Sacramento,CA 95©34)921-9600 U East 11115 Montgomery,Sude B•Spokane WA 99106•(5 4 92OU z <br /> A- <br /> U <br /> U 404 N W,get Lane•Walnut Creek CA 94598•(510)988 9600 U 15055 S W Sequoia Pkwy,Suite 1 10•Portland OR 97222•(50 624 9900 <br /> Consultant Company Project Name <br /> 4 <br /> Address UNOCAL Project Manager <br /> City _ `�t r ,, State Zip Code ; ` i 1 i , AFE 11 <br /> C <br /> a, <br /> Telephone FAX ff �� i 7, '1 Site it, City, State ` ` l= f l <br /> Re ortTo Wt ' F f L&-J-V', 4 Sam ler, OC Data ❑ Level D (Standard) ❑ Level C ❑ Level B ❑ Level A c <br /> ry <br /> Turnaround ❑ 10 Work Days 1:15 Work Days ❑ 3 Work Days ❑ Drinking Water [Analyses Requested <br /> Time ❑ 2 Work Das ❑ 1 Work Day 1212-8 Hours Waste Water <br /> CODE 1:1 Mtsc 1] Detect U Eval ❑ Remed ❑ Demol 1-1 Closure ❑ Other', 10,- 'ti'- <br /> L,1� <br /> Client Date/Time Matrix it of Cont Laboratory t <br /> Sample I D Sampled Desc Cont Type Sample# ;� Comments <br /> i�- I <br /> 0 <br /> 2 <br /> J <br /> 3 <br /> , <br /> 4 0 <br /> 5 <br /> s <br /> 7 <br /> 8 <br /> 9 <br /> 10 o <br /> co <br /> 0 <br /> .0 <br /> t co <br /> Relinquished By ' r' , Date ' Time Received By Date____-- Time <br /> _ 0 <br /> Relinquished By ' Date Time Received By - Date Time <br /> Relinquished By Date Time Received B Lab • �'`_) Date S V//i T(me %` 3 /0 <br /> Were Samples Received in Good Condition?U Yes 1] No Samples on Ice? U Yes U 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' U Yes❑ No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround lime? U Yes U No If no, what was the turnaround time? <br /> Approved by Signature __—_� __ ___ ___ _ Company _ __� _ _�� _�_�4�—Date __ <br />