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# b8U l,Itebdpedke Urive*Redwood Uty,W. J ruu.)•k4 I JJ Jb4 J600 U iti)J9 LdUthAve,NL,butte Ii •UUlltell, VVH UbUi1 •bunt-401 acuu UA C A L I U 819 Striker Ave,Suite 8•Sacramento,CA 959916)921-9640 U East 11115 Montgomery,Suite B•Spokane,WA 99206924-9200 U 404 N Wtget Lane•Walnut Creek,CA 94598•(510)988 9600 U 15055 S W Sequoia Pkwy,Suite 110•Portland,OR 97222)624-9800 Consultant Company Irle, Z-oi, 4 Zg7nL:s q.S Protect Name Forrrk-ar- 01-10CQ / s-S Jq_ ZITS-3 Address (.W7 S/errck QDgrt rSu1-t.Q. UNOCAL Project Manager 1Jr RoAel-f ,4 98,x.sf. City 40M 9 State (fi=t Zip Code c q_e=,F AFE# r Telephone �7zs� �/_�sSS FAX #Q r-)art ��' Site#, City, State !66-T- A, ,",L 4✓2- Re art To be_gr)nq L1�4vt Sam ter 7q_s 11 JQC Data oLevel D (Standard) ❑ Level C ❑ Level B ❑ Level A G Turnaround 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water JAnalyses Re uested � Cl&V6 G Cho a_ Time- ❑ 2 Work Das ❑ 1 Work Da 02-81-lours )I Waste Water -7 r, CODE: ❑ Misc ❑ Detect ❑ Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other r Cont Client Date/Time Matrix #of Laboratory � , w,c'� �, Comments Sample I D Sampled Desc Cont Type Sample# .( p Q ti 4 Z 1 r0-�� (0 N-/,Y- rIL v� Pte S� 3 3 P4, to 5 M ISI - ti 3;sE r� ti to } 6 M W ti 1);z AM X X a KtJ Z �om w - 71 D '� r X• X x X X co Relinquished 8y Z Date 6/ Time 7,-:24)f4 Received B Ime '3 a� Relinquished By Date Time Received By Date Time Relinquished By Date Time Received By Lab Date 4/10/.Time 44: Zn Were Samples Received In Good Condition?O Yes 0 No Samples on ice? 0 Yes 0 No MethC6 of Shipment Page—of_ To be completed upon receipt of report 1) Were the analyses requested on the Chain of Custody reported? U Yes❑ No If no, what analyses are still needed? 2) Was the report Issued within the requested turnaround time? D Yes IJ No If no, what was the turnaround time? Approved by _ __Signature —______ Company Date I